Plantar keratosis is a thickened area of skin on the sole of the foot caused by excessive pressure and friction. It commonly affects older adults and can cause pain, impaired walking ability, and reduced independence. There are two main types - discrete, localized to a single area, and diffuse, affecting broader regions. Conservative treatments include shaving, padding, and orthotics to redistribute pressure. For discrete lesions, surgical removal may be needed. Diffuse plantar keratosis is harder to treat due to underlying foot anatomy and may require scar tissue excision.

1. PLANTAR
KERATOSIS
Boby Harul Priono, d
Foot And Ankle Referat I
Pembimbing : dr. Andri primadhi Sp.O

2. Introduction
 Plantar = the sole of the foot.
 Keratosis = A localized horny layer (sratum
corneum) overgrowth of the skin, such as a
wart or callus.1
 Epidemiology
 > 65 years old (33-78%)2
1. Miller-Keane Encyclopedia and Medical dictionary 7th edition. Saunders. 2003
2. Landarf, Karl B, Adam Morrow, Anna Novak,Julia Potter. Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial.
Journal of Foot and Ankle Research 2009, 2:8 doi:10.1186/1757-1146-2-8

3. Why Important???
 Pain
 Reduced walking speed
 Impaired balance
 Reduced independence when walking
Landarf, Karl B, Adam Morrow, Anna Novak, Julia Potter. Effectiveness of scalpel debridement for painful plantar calluses in older people: a randomized trial.
Journal of Foot and Ankle Research 2009, 2:8 doi:10.1186/1757-1146-2-8

4.  The stratum corneum is composed
1. Ceramides
2. Cholesterol
3. Fatty Acids
 Function, Barrier of :
1. Infection
2. Dehidration
3. Chemicals
4. Mechanical stress

5. CLINICAL FEATURES
HISTOLOGY

6. Coughlin, Michael, Charles Satlzman, Robert anderson. Mann’s surgery of foot and an
Elseveier. 2014

7. How to make early diagnosis

9. Harris mat imprint of Plantar
keratosis

10. Causes
Coughlin, Michael, Charles Satlzman, Robert anderson. Mann’s surgery of foot and ankle. Elseveier. 2014

12. All causes
Localization of
pressure
Plantar keratosis

13. Plantar Keratosis Classification
 Discrete Intractable Plantar Keratosis

14.  Diffuse Intractable Plantar Keratosis

16. Therapy
 Conservative treatment
 SHAVING

18.  Padding

20. Operative treatment
A. Discrete IPK
 Calus under fibular condyle of metatarsal
head

21.  DuVries condylectomy

22.  Discrete Callus beneath Tibial Sesamoid

23. Operative Treatment (cont’d)
B. Diffuse IPK
Usually because of anatomic pattern of the foot.

27.  Scar Excision

28. Rehabilitation