Lister’s helomas are hyperkeratotic, round, inward growing lesions covered with callus. They appear when an area of skin receives excessive pressure from bone and footwear. They have a dark coloring and well-defined edges. They are generated from the deep layers of the skin. Surgical treatment consists of removing these bony prominences to eradicate the problem at its root.
A heloma is a benign skin tumour in the shape of a key that appears frequently in the points of the feet that receive intermittent and repeated pressure which stimulates the growth of the horny layer of the skin as a defence mechanism. It is also sometimes called pins or crow’s eyes. In general, it can appear in any area of the foot where there is pressure from the skin against a bony prominence on an intermittent and repeated basis.
As it is a biomechanical lesion, the lesion will remain in time as long as the conditions that caused it persist: narrow footwear, deformity of the toes, loss of plantar adipose tissue…
If specialized treatment is not received, the lesion may produce a collection of fluid under the heloma that may eventually become infected and affect deeper planes, leading to severe ulcers and infections. It is therefore important that patients with “risk feet” regularly visit the chiropodist for assessment and treatment of hyperkeratotic lesions.
Surgery is the treatment of choice when conservative treatments do not achieve the objective of eliminating pain, functional impotence and preventing the formation of ulcers. Surgery will be aimed at eliminating the mechanical cause that produces the helomas.