The shoe itself can even be a source of external pressure, although this is usually seen resulting in corns on the top of the toes (which is the same type of condition as a callus). Internally, pressure can come from the bones that lie beneath the skin. If the bones are abnormally prominent due to a foot structure abnormality (like a bunion or flat feet), or if the skin and padding below the bone is abnormally thin, then pressure will increase on the overlying skin.
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