A keratoma is a benign tumor of the inner layer of keratin-producing epidermal hoof wall cells that propagates inside a horse's foot. Usually it develops underneath the coronet, and grows down the foot with the normal hoof.
• 'Cylindrical'-shaped keratomas, that propagate in the hoof wall directly towards the sole.
• More discrete 'spherical'-shaped keratomas, most often towards the toe.
Being a tumor, we do not know the precise causes, but infections and wounds affecting the crown, may represent the starting points of this disease.
The first sign indicating the presence of a Keratoma could be the lameness, because of the linked pain. Visually it is possible to notice a discontinuity in the white line under the sole. The keratoma grows and deviates the line. To be sure of the diagnosys, an x-ray examination is required; Magnetic resonance imaging (MRI) has also been used to define accurately the margins of the abnormal tissue and the extent of the damage, making it easier to decide how to treat it.  Precise confirmation of the diagnosis can be achieved by examining a processed microscopic section (histological examination) of the removed tissue.
The only way to treat a keratoma Is surgical removal. Keratomas are benign tumors, they do not metastasize or spread to other parts of the body, but sometimes they recur at the same site, following incomplete surgical removal. It is important to identify and remove the top end of the tumor beneath the coronary band, which means the surgeon often has to remove a relatively large area of horn up to the coronet. In the immediate postoperative period, wound dressings are applied and changed regularly to control bleeding and infection. The foot is bandaged or preferably fitted with a hospital plate.
A hospital plate is an aluminium plate specifically made to fit over a specially made shoe and makes easier the management of the wound. Antibiotics and Tetanus antitoxin must be given, together with box rest and regular bandage changes. The foot needs to be bandaged until a hard layer of horn has formed over the area. This process will require a long healing time depending of the size of the tumor, considering that the hoof wall grows only about ½ cm per month 
To facilitate the wound healing, PRP (platelet-rich plasma ) can be used on the wound site. Jacqueline suffered of hoof keratoma. After surgical removal of the mass, the veterinary applied Ematik Ready directly on the site. Ematik ready is a moist bioresorbable veterinary patch soaked in PRP obtained from patient’s own blood. The wound was considered clinically healed only after 20 days from the first application of the Ematik treatment, obtaining excellent quality of regeneration with a complete reconstruction of the hoof.
Jacqueline day 1
Jacqueline day 3
Jacqueline day 6
Jacqueline day 20