Common Foot Disorders Flashcards
factors contributing to corns and calluses
friction from loose or tight fitting shoes not wearing socks with shoes ill fitting socks walking bare foot weight gain
what does a corn look like
small raised and well defined lesion
has a central core that is triangular shaped and points inward (hole in middle)
signs and symptoms of a hard corn
well defined
yellowish grey
mm-cm diameter
shiny, dry, and polished with loss of natural skin pattern
central core visible
pain
occurs on skin directly overlying bony prominence or on soles of feet
usually surface of the fourth or fifth toes
signs and symptoms of soft corns
whitish thickenign of skin
soft appearance
WEBS between 4th and 5th toes
may be painful
what is a plantar corn
corn on the underside of the foot that causes pain when walking
signs and symptoms of a callus
yellowish white
normal skin pattern with no central core
borders not well defined
few mm -cm diameter
slightly elevated
where upper layers of skin are naturally thick
what are plantar warts
benign tumors caused by HPV viral infection
why is it important to treat plantar warts when they are benign and will spontaneously clear
can spread
unsightly
can be painful and restrict activities
may transform into malignant lesions
where can plantar warts occur that is not a referral
sole of foot or heel
great toe
head of metatarsal bone
what are signs and symptoms of plantar warts
circular lesion with wart in the center .5-3 cm diameter surfacr rough and grayish brown, easily crumbles surrounded by skin that is thick and heaped normal pattern of skin is interupted black dots in center of lesion single or in clusters painless unless direct pressure applied
difference between athletes foot and soft corn?
athletes foot is itchy not painful and may have an odor
goals of therapy for corns and calluses
remove corn and calluses
prevent/minimize complications
prevent recurrence
what is the first line treatment of corn and calluses
salicylic acid
advantages of sa collodion
forms film to prevent moisture loss
less likely to run onto other areas of skin
disadvantages of sa collodion
takes longer to resolve
occlusive nature allows systemic absorption
more irritating
advantages of plasters/disk/pads
direct and prolonged contact with skin
plasters may be cut to fit size of lesion
disk/pads convenient
disadvantages of plasters/disks/pads
patient may be sensitive to adhesive
what should collodions be used for and for how long
soft corns
3-6 days
what should the adhesives be used for and how long
hard corns and calluses
5 treatments over 2 week period max (1treatment = 48hrs)
until condition resolved
directions for use of collodion
soak foot for 5 min and dry
apply 1 drop at a time until area i well convered
allow drops to dry and harden
do not let adjacent areas of skin come in contact with drug (put vaseline on skin around)
once or twice daily
directions for use for plasters
soak foot for 5 minutes and DRY
trim to follow contours of lesion
apply and cover with adhesive tape
remove within 48 hours
directions for use for disks and pads
soak foot for 5 minutes and DRY
apply appropriately sizzed on area and cover
remove within 48hours
what should you do along with all of the treatments
soak in warm water and remove dead tissue with a pummice stone or callus file
non pharms for corns and calluses
eliminate cause of condition foam or cushion pad with opening to relieve pressure- change everyday custom pads from moleskin or lambs wool orthotic devices keep feet clean and dry avoid moisturizers between toes select properly fitted footwear
monitoring for corns and calluses
visible improvement in a few days
resolution for hard corn/callus in 14 days, 3-6 days for soft corn
refer to doctor if allergic reaction develops, skin irritation, skin ulcers, stinging that is bothersone, infection develops (red, warm, discharge)
goals of therapy for plantar warts
alleviate or prevent pain due to wart
eradicate lesions adn prevent their proliferation
prevent recurrence
prevent transmission
what is the first line treatment for plantar warts
salicylic acid
how does sa work
keratolytic
removes skin cells infected with HPV and causes inflammation which induces an immune response
how does lactic acid work
corrosive properties
enhances sa
how does formalin work
antiviral and anhydrotic
how does cantharidin work
vesicant which causes blister to form and cells die
how does DME and propane work
freezes wart and causes a blister to form under it, wart falls off 10-14 days after treatment
SA treatment options for plantar warts
sa collodion- OD–BUD max 12 weeks
sa plaster/disk- wvery 48 hours for max 12 weeks
sa in karaya gum- apply at night for 8 hours for max 12 weeks
other product for plantar warts
wartner and freezeaway- apply to wart for 10-40 seconds may repeat in 14 days up to max of 3-4 times
non pharms for plantar warts
advice they are contagious
avoid walking barefoot
change shoes and socks daily
keep feet clean and dry
dont share or touch possible infected objects or peopls
wash hands before and after cleaning feet and caring for wart
do not bite, scratch, poke, or cut wart tissue
dont use sharp knives or razors
use good foot hygiene
how can duct tape be used for plantar warts
cause irritation
apply to wart for 6 days then remove and soak foot
soak throughout treatment for 5-10 min in warm water and gently remove dead tissue
can take up to 2 months not the best option
monitoring for plantar warts
improvement should be seen in 1-2 weeks
wart removal may take 4-12 weeks
warts may reappear months after initial treatment
refer to doctor if develop an allergic reaction, skin becomes damage painful inflamed or infected, if any wart persists after 12 weeks of treatment
side effects of SA
redness burning or irritation
when should you not use SA
irritated, infected skin face, mouth, nose, anus, genitals, lips patient takes salicylates, anticoagulants, LMW heparin pregnancy and breastfeeding?? under 3 or over 65
precautions of SA
apply petroleum jelly to surrounding skin
highly flammable
poisonous if swallowed or inhaled
side effects of DME/propane products
aching, itching, burning,stinging, dont use on thin skin can cause scars
precautiosn of DME/propane products
unknown in pregnany and lactation
not in under 4
not in hard to reach location
flammable only one wart at a time on toe
what is a bunion
deformed big toe joint
joint angled out and big toe angles inward toward other toes
can also be on 5th toe
factors contributing to bunion
inherited women constatn abnormal joint motion improper fitting shoes or high heels occupation that puts stress on feet vigorous exercise foot injurues rheumatoid arthritis
signs and symptoms of bunions
usually bilateral bump on outside edge of big toe thickening of skin at base of big toe asymptomatic but can become red, painful, swollen, tender restricted movement of big toe
bunions are a referral what can you do in the meantime
remove source of irritation
select properly fitting footwear
modify activity
moleskin, foam, cushioned pads
bunion guard- soft polymer gel with no adhesive
ice packs and OTC pain relievers to decrease pain and swelling
red flags for warts
extensive at one site
on mucous membranes, face, anus, genitalia, under nails
extremely painful and debilitating
unusual appearance
red flags for corns or calluses
indicate an anatomic defect or fault in body distribution
lesion oozing purulent material or is bleeding
extensive, painful, or debilitating
red flags for all foot conditions
diabetes, peripheral circulatory disease malnourishment immunocomprimised rheumatoid arthritis physical/mental impairments making following instructions difficult allergic to treatment options - ASA, adehsive proper self medication has been unsucessful under 3 or over 65 pregnan infected, red, swollen, inflammed looks like mole or birthmark hair growing from lesion
