Use of hyaluronic acid gel filler versus sterile water in the treatment of intractable plantar keratomas: a pilot study.

BACKGROUND: Intractable plantar keratoma is a common concern in the podiatric medical office. Different treatment options are available, ranging from trimming and padding to surgery. We sought to investigate the use of hyaluronic acid gel injections as a possible minimally invasive alternative in the treatment of intractable plantar keratomas.

METHODS: Seventeen patients with intractable plantar keratomas were randomly assigned to receive a hyaluronic acid gel injection or a sterile water injection at the site of a previously trimmed plantar lesion.

RESULTS: There was no significant difference between the two groups in the evaluation of pain and function at 12 weeks, but both groups showed a clinically relevant improvement. No significant change was observed in plantar tissue thickness in both groups. A minor adverse reaction was seen in the hyaluronic acid group.

CONCLUSIONS: The use of a hyaluronic acid gel injection at the site of a trimmed intractable plantar keratoma did not seem more effective than the use of a sterile water injection. Sterile water injections seemed safe and efficient in reducing pain associated with plantar keratomas. Further investigations should concentrate on whether these results are reproducible in a larger sample and on the most effective sequence of treatment.