Foot Conditions

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Callous

  • It is a yellow, white or brown thickened area of the skin caused by friction from footwear, abnormal foot function, or abnormalities of the bones. As the skin becomes less elastic they tend to burn and eventually split causing fissures. Footwear must be assessed to see how it fits, foam padding may be applied, and daily use of quality emollient, such as Uremol 10%, is suggested.

Corn

  • There  are hard corns, soft corns, and seed corns. Hard corns look like layers of thickened skin with a delineated nucleus in the middle and are caused by intermittent compressional stress due to pressure from shoes on a bony prominence or joint deformity. It can lead to a painful inflammation of the underlying bursae called bursitis. Soft corns appear over a bony prominence in the interdigital space caused by compressional stress between the joint prominence of adjacent toes. Seed corns are tiny bead-like corns that appear on the plantar surface of the foot and occur with dry skin and callous.
  • Some corns can be denucleated with a black’s file but if painful and inflamed – gently file it and apply emollient. Avoid medicated corn removers. If using corn pads use nonmedicated ones and cut them into a horseshoe shape to keep the corn from bulging. There is a need for properly fitting footwear, assess for padding, and refer to foot specialist if pain persists and there are symptoms of infection.

Plantar Wart

  • Benign skin tumour non-malignant and caused by a virus. It may look like a cauliflower or flattened with red and black dots. It is contagious and painful when pinched. As a person becomes immune to it the wart will disappear. Keep the area dry by applying clear nail polish onto the wart when swimming since water causes warts to grow. Use good hygiene. Wart removal products are recommended unless client has

Athlete’s Foot

  • Fungal infection of the skin of the foot. The skin is patchy red, scaling, macerated, fissured, and may burn or itch. Soak feet in a ¼ cup of vinegar in a basin of water 3 times per week. Change socks and wash feet daily, dry between the toes, wear cotton socks, place footwear in a bag in the freezer for 48 hours. Meticulous foot hygiene is essential.

Flat Foot

  • The inner arch of the foot is flattened and the foot is pronated. The foot is flexible but a poor shock absorber. This leads to problems with and pain of the ankles, knees, hips, and back. Lack of fatty tissue on the soles of the feet leads to callouses forming at the inner arch. The client will need orthotics and supportive footwear as well as not going barefoot.

High Arch

  • The inner arch of the foot is abnormally high. The foot is supinated and less flexible. The heels are calloused and the 1st and 5th metatarsophalangeal joints often have corns. The client is likely to have stress fractures and ankle sprains due to foot rigidity. Supportive footwear with built up arch support and not tying the shoe laces too tight are suggested.

Bunion

  • Deviation of the great toe toward the second toe and medial protrusion of the first metatarsal head. A callous or bursa may develop over the joint and the second toe may become hammered. The causes include: hereditary, rheumatoid arthritis, and footwear with narrow toe box and high heels. Make sure the footwear has a wide and deep toe box to accommodate the bunion. Toe separators, foam padding, bunion brace (splint), or lamb’s wool may be used to pad the bunion and separate the great and second toe. The client would benefit from orthotics.

Mallet Toe

  • It is when the distal interphalangeal joint is perpetually flexed and contracted. It most often occurs in the second toe. The client will need footwear with a deep toe box.

Hammer Toe

  • This is when the proximal interphalangeal joint and sometimes also the distal interphalangeal joint have flexion contracture. It often happens with the second toes when there is a bunion and pressure from the great toe. In this case footwear with a deep toe box is also needed.

Claw Toe

  • Toes are positioned like a claw; interphalangeal joints are flexed but not contacted. This happens to all toe but not the great toe.

Involuted  Toenail

  • One or both sides of the nail become curved and dig into the skin. This can be caused by heredity or ill-fitting footwear or hosiery. There is a high chance of ingrown toenail unless the nails are kept very short and regular footcare is done. The corners of the nail may need to be packed. Make sure the footwear has enough toe width and depth.

Ingrown Toenail

  • The side of the nail pierces through the skin of the toe causing redness, inflammation, and pain. If left untreated it will become infected. This may be caused by incorrect nail cutting, involuted toenail, trauma to the toenail, insufficient length and width of toe box, and biomechanical imbalances. If appropriate the part of the nail cutting into the skin should be removed and filed down with black’s file. Afterwards, cleanse site with antiseptic and apply sterile dressing as well as for days afterwards until healed. Assess footwear’s toe box. If intervention is not appropriate a physician or foot specialist should be seen immediately.

Fungal Toenail

  • Fungus infects the nail causing it to yellow, thicken, split, and become disfigured and discoloured. It can also spread to the skin and cause athlete’s foot. It is contagious and can spread through the common use of towels or nail instruments. A bacterial infection can gain entrance at the point of previous injury and cause Paronychia characterized by inflammation to the tissue and unpleasant odour. Use good hygiene to prevent the spread of infection, reduce nail bulk through filing while using an N95 mask, and assess for bacterial infection. Avoid tight shoes, obtain regular footcare, and treat shoes and slippers with antifungal agent. Treatment options include an antifungal nail polish or an oral medication (with many side effects).

Ram’s Horn Toenail

  • A nail that grows in a thickened spiral shape that resembles the shape of a horn. Usually this is caused by an injury to one side of the nail so that one side grows normally but the other side grows in an irregular way. Support the nail plate while cutting the nail to prevent twisting and reduce nail bulk by filing it down. Make sure the footwear fits properly and that nail care is done regularly.

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