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Pathologies

Knowledge is Power, Empower Yourself!

Callus


A callus is the cause of pressure and friction. Adjusting foot wear, assessing the gait, and addressing skeletal deformities will reduce friction and pressure, allowing the skin to rest and to stop forming protective skin coverings. Nurses will reduce the thick skin and assist you with determining why the callus formed to prevent its recurrence. Calluses are a high risk pathology. This is because under this hard thick skin is very soft tissue that is constantly being rubbed and pressed on. This can often cause an ulcer or wound to form under the callus.


Warts


Caused by HPV (human papilloma virus), plantars warts often appear on the bottoms of your feet, and can be painful and unsightly. We don’t recommend over-the-counter medications because they may damage healthy tissue around the wart and contribute to spreading. We may recommend a couple of treatments. it is important to have an appointment to determine the extent of the infection.


Skin Cancer


Skin cancer can develop anywhere on the body, including in the lower extremities. Skin cancers of the feet have several features in common. Most are painless, and often there is a history of recurrent cracking, bleeding, or ulceration. Cancers can also form in the nail. Frequently, foot care nurses are the first to discover the skin cancer during their assessments.


Tinea Pedis (Athlete's Foot)


Tinea pedis is the term used for a dermatophyte infection of the soles of the feet and the interdigital spaces. Tinea pedis is most commonly caused by Trichophyton rubrum. Athlete's foot is a fungal infection that affects the upper layer of the skin of the foot, especially when it is warm, moist, and irritated. It is as also known as tinea pedis and ringworm of the foot. The fungus that causes athlete's foot is called Trichophyton and is commonly found on floors and in clothing. Most often if a person has athletes foot they will also have toe nail fungus, and vice versa.  It is highly contagious. Soft Soles Nurses have tried and true treatments for this annoying little dermatophyte!


Maceration


Maceration occurs when skin is in contact with moisture for too long. Macerated skin looks lighter in color and wrinkly. It may feel soft, wet, or soggy to the touch.

Skin maceration is often associated with improper drying. In addition to the pain and discomfort it causes, maceration can also slow wound healing and make skin more vulnerable to infection. Always dry between the toes well. If you cannot reach your toes use a blow dryer.


Fissures


Heel fissures, also known as cracked heels can be a simple cosmetic problem and a nuisance, but can also lead to serious medical problems. Heel fissures occur when the skin on the bottom, outer edge of the heel becomes hard, dry and flaky, sometimes causing deep fissures that can be painful or bleed. This can lead to infections and adds a higher risk for people with circulatory issues. Fissures can be a sign of an underlining health issue such as vitamin deficiencies, obesity, and circulatory issues. Soft Soles nurses have a number of treatment plans that will put a stop to heel fissures.


Ingrown Toenails


Ingrown nails, one of the most common problems we see in our foot clinic, can be caused by wearing shoes that are too tight in the toe and/or not cutting your nails straight across. They are uncomfortable and if left untreated, can cause severe pain.

We will recommend treatment based on the severity of the infection including water and salt soaks, antibacterial ointment, nail braces, and packing.


Corns 

And Calluses



Thick, hardened layers of skin, caused by tight-fitting shoes or a biomechanical foot fault, can be uncomfortable and unattractive. We will remove corns and reduce calluses quickly and easily, and offer self-care recommendations padding and footwear advice to help you keep your feet comfortable and looking great.


Involuted nails 


These are nails that press into the skin around the edges of the nail.

They don’t actually break the skin and usually don’t become infected . There is sometimes a large amount of hard skin under the edges of the nail .This can increase the pressure even more on the underlying skin and make the toes very painful. Careful clipping and removal of the hard skin usually fixes them ..But the nail regrows over time in the same way and sooner or later the nail problem returns. If the nails are a long-standing problem, then a small brace is applied to the nail and will correct the way the matrix of the nail is formed.

This  can resolve the problem completely. Nurses can also instruct you in proper nail cutting technique so that the curved bits don’t press into the skin.


 Ingrown toenails 


These are what most people recognize as a bad toe problem. They can be very painful, infected, swollen, smelly, and have lots of pus! Ingrown toenails are often caused by poor cutting technique; toe nails that are clipped too short or when the sides of nails are dug or picked can often turn into nasty ingrown nails. If you're quick to do something about it (come to the foot care nurse!!), then a major problem can often be avoided. Playing around with the toe often makes it worse and the toe can swell and become infected very quickly. A good tip is: if you think you’ve got a problem, bathe the whole toe in a bowl of warm salty water and call for an appointment.  Soft Soles nurses can help remove the sharp spicule that is the problem and help you avoid having this issue again.


Nail psoriasis


Nail psoriasis alters the way your toenails and fingernails look. They may get thick, develop pinprick holes, and change color or shape. They also can feel tender and hurt.


Onychauxis


Onychauxis is the name of the condition when fingernails or toenails start growing abnormally thick and begin to turn yellow. Onychauxis is not a form of toenail fungus and the nails grow thick without the presence of deformity. Your foot care nurse can help you determine if you have onychauxis, gryphosis, or mycosis.


Subungual hematoma


Subungual hematoma is the medical term for bleeding and bruising under the nail. This is usually the result of some kind of injury to the blood vessels under the nail bed. For example, blood vessels can break and leak blood into the area underneath the nail when a door slams on a finger or a heavy object crushes a toe.


Diabetes Care


For diabetics, we recommend regular foot care, with the frequency depending on the seriousness of your condition and on the extent to which you are able to care for your feet yourself. We will examine your feet on a regular basis and recommend treatments to help maintain your foot health – and your overall well-being.

Please note: If you have cuts, wounds or other injuries to the feet, call us immediately. Do not wait to see if things heal on their own; with diabetes, there’s a good chance that the condition will get worse and it’s easier to treat it earlier than if it progresses into an infection.


Corns: Causes

Corns are caused by pressure and friction.  To treat the corn, it must be removed, the pressure or friction addressed, and the area offloaded.

Hard Corns (Heloma Durum)

These corns are normally found under the foot, the side of the foot, and the tip of the toes.



Soft Corns (Heloma Molle)

A soft corn is found between the toes. The first indication is a burning sensation in the area, usually followed by a formation of a blister. This area is kept moist by perspiration and a soft corn is the result. A fully developed one will produce a sensation of a small stone or a few grains of sand between the toes. Corns found between the fourth and fifth toes are notoriously painful.

Seed Corns (Heloma Miliare)


These corns are the size of a pinhead and can be either in small groups or singly. They can also develop under the nail and cause considerable pain.

Neuro-Vascular Corns


Similar to vascular corns, but with this one, nerve endings as well as blood vessels are involved in the growth. When they are fully developed, they become transparent with clearly visible zigzag lines with.

Vascular Corns (Heloma Vasculare)

Vascular corns are seen as an overgrowth of the skin tissues in which enlarged and elongated blood vessels are to be found. This growth is usually found under the foot.

Nail Fungus

Onychomycosis (or Nail Fungus) Causes, Symptoms, and Treatment Options


Onychomycosis (ŏn’ĭ-kō-mī-kō’sĭs) is used to describe fungal infections of the fingernails or toenails, i.e.: fungal nail.


Causes

There are a number of causes for onychomycosis or fungal nail; these might consist of:

Inadequate personal hygiene

An overabundant use of nail polish

Walking barefoot through public areas

Direct contact with another infected person

Nail care tools that are not properly disinfected

 

It is highly contagious.

Symptoms

Onychomycosis symptoms can present in several different ways, including one/more of:

Brittle/broken nails

Thickening of the nail

Discolouration of the nail

A foul and unpleasant odor

Toe pain when wearing shoes

Scaly skin immediately next to the nail

Treatments

Onychomycosis or nail fungus treatment options can include over-the-counter or topical agents, but they will likely be less effective than prescription anti-fungal medications such as Lamisil, Sporanox, and Jublia. These latter types of nail fungus treatments help new nails grow back free of infection to replace the affected portions; however, this can be a slow process, often taking 6 to 12 weeks, and it can be quite expensive, especially for those who do not have medical insurance/coverage.

Soft Soles Nurses are experienced at reducing the nail fungus and helping you pick the treatment plan that works for you financially as well as medically. 

Genesis Light Therapy

Genesis Light Therapy is a photodynamic therapy that involves three key components: a photosensitizer (which is a chemical compound that can be promoted to an excited state when it is exposed to a specific wavelength of light), a light source, and oxygen. When this photosensitizer is exposed to a specific wavelength, it produces a charged oxygen atom. This high energy atom “attacks” any organic tissue it encounters, thus making it highly cytotoxic, resulting in cell death.

The way this therapy works is by mechanically debriding the infected toe nails. The methylene blue is applied to the toe nail then the methylene blue is subjected to a light source of 640-660 nm (red), and a brightness of 4,000-6,000 lm for 5-7 minutes. Typically, 3-4 treatments are required, with a 1-4 week interval between appointments. This therapy is painless and will improve the look and strength of your nails.