Management of Plantar Callus and Wart

Initial Diagnostic Approach

The American Diabetes Association recommends performing monofilament testing (10-g Semmes-Weinstein) to assess for loss of protective sensation in patients with diabetes or suspected diabetes 1, 2
Palpation of pedal pulses and assessment for peripheral arterial disease is crucial in patients with diabetes or suspected diabetes 1, 2
Inspection for erythema, warmth, or signs of impending tissue breakdown around the lesion is necessary in patients with diabetes or suspected diabetes 1, 3

Debridement of the callus with a scalpel (performed by a trained foot care specialist) is recommended until the callus resolves and does not recur 1, 3
Pressure redistribution through well-fitted walking shoes or athletic shoes that cushion the feet and redistribute plantar pressure is essential to prevent recurrence 1, 2
The American Diabetes Association recommends that patients with diabetes never walk barefoot, in socks only, or in thin-soled slippers at home or outside 4, 5

Comprehensive foot examination, including assessment of protective sensation, foot structure, vascular status, and skin integrity, is necessary for patients with diabetes 1, 2
Visual inspection at every healthcare visit is recommended if neuropathy is present in patients with diabetes 1, 2
Referral to a multidisciplinary foot care team is necessary if there is a history of prior ulceration, amputation, or loss of protective sensation in patients with diabetes 2, 6

Daily foot inspection for new lesions or changes is recommended for patients with diabetes 3, 4
Proper footwear at all times (never barefoot or in thin slippers) is essential for patients with diabetes 4, 5
Immediate reporting of any warmth, redness, or drainage is necessary for patients with diabetes 3
Adherence to offloading footwear is critical for resolution in patients with diabetes 5