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32-Year-Old Male with Painful Lesion on Sole

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

A 32-year-old male construction worker presented with a painful lesion on his left sole. The lesion was first noted 1 to 2 years prior and gradually increased in size with time. The lesion was asymptomatic initially and became slightly painful in the past 6 months, especially with standing and walking. The patient was otherwise in good health. In particular, there was no history of diabetes, rheumatoid arthritis, or neurological disease.

The patient had a hyperkeratotic, thickened plaque on the left sole. The lesion was poorly demarcated and was tender when direct firm pressure was applied to it. The rest of the physical examination was normal.

What’s your diagnosis?

Choose one to reveal diagnosis and discussion

Plantar wart
Plantar callus
Plantar corn
Dermatofibroma
Keratoacanthoma

Answer: Plantar callus

See the full case at Consultant360

The patient had a plantar callus (also known as callosity). It was treated by deep paring and followed by application of a urea-based cream nightly. An assessment for orthotics was scheduled. The lesion resolved in approximately 2 months.

A callus refers to a diffuse thickening of the stratum corneum in response to repeated or chronic friction or pressure.

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