Athlete’s Foot

Authored by Dr. Gennady Kolodenker
Reviewed by Dr. Mark Landsman

• Overview
• Athletes Foot Symptoms
• What Causes Athletes Foot
• Diagnosing Athletes Foot
• Athletes Foot Treatment
• Preventing Athletes Foot
• Complications of Athletes Foot
• Talking to Your Doctor

Athlete’s foot is a contagious fungal and bacterial infection that occurs on the feet, usually between the toes (typically the fourth and fifth toes), on the soles, or on the sides of the foot. It can cause the feet to itch, burn, and become dry and flaky, and can cause discomfort as the condition spreads and worsens over time. Athlete’s foot is medically known as tinea pedis, or ringworm of the feet.

Athlete’s foot is so named because many sufferers are athletes, who spent a lot of their time sweating and going into public showers, gyms, locker rooms, and other damp, warm places. Many people know that you don’t have to be an athlete to suffer from athlete’s foot. Fungi thrive in warm, damp places. Our shoes are a perfect example. During warmer weather, doctors see an increase in athlete’s foot.

Athlete’s Foot Symptoms

Athlete’s foot is said by sufferers to begin with a mild itching sensation. As the condition persists, scales begin to form in the same area. The scales are usually soft, moist, and either red or grayish-white in color. In most cases they begin to form around the toes, but they have also been known to appear on the sides of the feet, on the heels, or on the soles. Occasionally blisters develop on the feet. Some athlete’s foot sufferers say their feet smell damp and moldy.

Call your doctor immediately if you are experiencing these symptoms, which may be signs the infection is spreading:

• Your foot is swollen and warm to the touch
• There are red streaks throughout the swollen areas
• Pus or discharge is present
• Fever

Athlete’s foot can sometimes spread to the hands and face, but these cases are extremely rare. Diabetics need to be extremely aware of the health of their feet. If you have diabetes and contract athlete’s foot, you should contact your doctor immediately.

What Causes Athlete’s Foot?

This condition is usually caused by a fungus and bacterial infection, which is spread by direct contact with someone who is already infected. Athlete’s foot can also be caused by:

• Being in contact with warm, damp places
• Sweating a lot
• Wearing closed shoes, especially ones with plastic linings
• Poor hygiene, including not washing feet properly or wearing dirty socks
• Not drying feet after being in contact with water
• Keeping feet wet for long periods of time
• Constantly using locker rooms, public showers, or gyms
• History of atopic eczema
• People with weak immune systems
• Illness
• Medications

All the items listed above increase the risk for developing athlete’s foot. For example, if you don’t regularly wash your feet with soap and water, or if you do not wash your socks every time you wear them, you are at a higher risk for developing athlete’s foot. Also, if you frequent public places that require you to be barefoot even for a moment—for example, if you change in a locker room or use a public shower—you are increasing your chances of developing this condition. Additional risks that may increase your chances of contracting athlete’s foot include:

• Living in hot, humid weather
• Persistent moisture around your feet
• An immune-system problem due to illness or medications
• Inherent susceptibility

Diagnosing Athlete’s Foot

Some people feel they can diagnose themselves with athlete’s foot, but most foot doctors would rather you make an appointment to see them before self medicating. If you are experiencing any symptoms of athlete’s foot, let your doctor know immediately. He or she will probably take samples of the scales to test in a laboratory to rule out other skin conditions. Your doctor should be able to diagnose you properly upon examining your skin sample. If your doctor feels tests are needed, they may include one or more of the following:

• Skin culture: Doctors take samples of fungi and skin from the patient and grow them in their lab.
• Skin lesion biopsy: Scrapings of skin are taken and examined under a microscope.
• Skin lesion KOH exam: KOH is the forumula for potassium hydroxide in liquid form. This exam uses scrapes of lesions that are placed in the KOH and examined under a microscope.

Athlete’s Foot Treatment

Your foot doctor will know the best treatment options for you. He or she may recommend the following treatment and prevention methods:

• Medications may be prescribed, such as Griseofulvin, Terbinafine (e.g. Lamisil AT), Miconazole (e.g. Micatin), Clotrimazole (Lotrimin AF), Tolnaftate (Tinactin) or Ketoconazole.
• Daily washing of the feet.
• Thorough drying of the feet after contact with water or warm, damp places.
• After drying feet, carefully remove scales and material between the toes each day.
• Use a blow dryer to ensure they are completely dry.
• Antifungal medication, either topical or oral, prescribed or nonprescription strength depending on the severity of your problem. Continue use of these products for one to two weeks after the infection clears up, or follow your doctor’s instructions.
• Wearing dry, airy shoes and socks.
• Not borrowing footwear from others.
• Avoiding tight hosiery.
• Foot powder to keep feet dry.

Although medical care is typically not needed to treat this condition, you should always talk with a professional about home treatment methods. You may begin to see relief within days. It’s very important that you seek help from a foot doctor if you are experiencing symptoms of athlete’s foot. Your doctor will be able to help you treat the condition and prevent it from reappearing.

Constant awareness is also important. If your routine activities put you at higher risk for athlete’s foot, you may need to learn to incorporate preventive measures into your daily routine. Athlete’s foot and other fungal infections can be stubborn at times. Occasionally, the problem can become chronic. Again, this is why it’s important to seek medical attention as soon as symptoms of athlete’s foot appear. In most cases, treatment is successful within three weeks.

Preventing Athlete’s Foot

There are several things you can do to prevent athlete’s foot from occurring:

• Bathe your feet every day and dry them completely between the toes.
• Apply a drying or dusting powder if you have sweaty feet.
• Wear rubber or wooden sandals when using public showers, pools, locker rooms, etc.
• Avoid synthetic materials. Wear socks made of cotton, wool, or other natural, absorbent fibers, especially in hot, humid weather.
• Air out your shoes between uses.
• Stop using old, worn-out shoes.
• Change your socks every day, especially in warm weather.
• Avoid walking barefoot in public places, especially on surfaces on which fungus often grows.
• Do not share towels or nail clippers with someone who has athlete’s foot.
• In warm weather, wear open shoes such as sandals, or shoes made of breathable materials.
• While at home, go barefoot in order to air your feet out.

To prevent this condition from recurring, avoid activities that may make your feet sweaty during the healing process. You should not need to change your diet to treat or prevent this condition, but you may want to watch your pets for fur loss. If you see fur loss, take your pet to the vet immediately.

Complications of Athlete’s Foot

There are a few complications that may arise if you suffer from this condition, including:

• Skin rash may develop on the hands and face (this is very rare)
• A secondary bacterial infection may develop in the affected area
• Recurrence of condition
• Systemic side effects of medications
• Lymphangitis (infection of the lymph glands, typically in response to bacteria, fungus, or viruses)
• Cellulitis

Talking Your Doctor

Here are some questions you may want to ask your doctor about athlete’s foot:

• Based on my activities, how likely is this condition to recur?
• Why are my feet sweating so much?
• Can I bring my shoes in to our next appointment so you can verify that they are the right type of shoe for me?
• Is it okay for me to wear socks at night to keep my feet warm?
• Which over-the-counter antifungal powder do you recommend?
• What temperature should my bathwater be?

Corns on Your Feet!

Corns on Feet

Authored by Dr. Patrick DeHeer
Reviewed by Dr. Mark Landsman

• Overview
• Corn on Feet Symptoms
• Corn on Feet Causes
• Should I See a Doctor?
• Diagnosing Corns on Feet
• Corn on Feet Treatment
• Preventing Corns on Feet
• Talking to Your Doctor

Also called helomas, corns on our feet are the result of too much friction on the skin of a toe and too much pressure on the bone. In most cases, ill-fitting shoes contribute to the problem. Thick skin forms to protect your feet, thanks to a defense mechanism built into your skin. Corns affect people of all ages (except infants), and are seen most frequently in African Americans. If left untreated, they can grow to become large and painful.

There are two types of corns: hard and soft. Hard corns are more common and usually form on the top of the toe or on the side of your foot. They are usually caused by improper footwear and toe deformities. Soft corns usually form in between the toes, where the moisture keeps them soft, and are caused by abnormalities of the toe bone or by shoes with narrow toe-boxes (high heels are one example).

Symptoms of Corns

Developing corns thicken the skin in the area where the corn is forming. The most common spot for them to appear is on the toes. Corns are typically 3 mm to 10 mm in diameter and have a hard center. You may experience the following symptoms if you have a corn on your foot:

• Tenderness
• Thickness of skin
• Hardening of skin
• Irritation while wearing shoes
• Pain

Causes of Corns on Feet

Corns are usually brought on by excessive friction and pressure, such as may be caused by ill-fitting shoes, although toe deformities can also cause corns to develop. When the skin is stimulated by friction and pressure, it automatically tries to protect itself. The cells in the irritated area begin to grow at a faster rate, leading to an overgrowth. When the pressure and friction continue for a long time, large corns develop.

Should I See a Podiatrist?

Anytime you feel you need a medical opinion you should see a doctor, regardless of your problem. No medication exists that cures corns, but there is medication to ease the symptoms. This is why it’s important to see a podiatrist if you are developing corns. If self-treatment fails, or if there are signs of infection, contact your doctor immediately. Signs of infection include redness, pain, heat, tenderness, or swelling.

Diagnosing Corns on Feet

Most podiatrists will be able to diagnose corns on your feet with a simple physical examination. Occasionally skin biopsies and x-rays are taken to determine whether there are additional abnormalities in the foot and skin.

Treatment of Corns

Treatment of corns usually begins with focusing on the cause of the problem, since corns do not always respond to medication. Stubborn corns are sometimes caused by an underlying condition such as diabetes, which makes people more susceptible to corns, calluses, and blisters on the feet. A person with diabetes or another disorder that causes poor circulation wouldn’t benefit from corn plasters. Corn plasters can sometimes even cause foot ulcers, which can complicate the situation further, possibly requiring amputation of the affected foot. Common treatment options for corns on the feet include:

• Medication
• Corn paints
• Corn plasters
• Special orthotics to redistribute and transfer pressure on the foot
• Change in footwear; avoiding certain shoes such as high heels
• Antibiotics may be prescribed if there is an infection
• Cortisone drug injection to reduce swelling or pain
• Cut or burn off corn with topical acid solution (when other methods fail)
• Surgically remove the bone in the toe that is responsible for the corn

Here is another common way to eliminate corns:

1. Peel the upper layers of the corn once or twice a day
2. Apply a nonprescription 5% or 10% salicylic ointment after peeling
3. Cover with adhesive tape

The goal of treatment is to reduce pressure and friction. This can be done in a number of ways, but your doctor will know which method is best for you. If the toe is not flexible, surgery may be performed to remove the corns. Unfortunately, corns do not have a root to remove to prevent them from recurring. This is why it’s important to eliminate potential causes. With treatment, corns should not take more than a few weeks to disappear.

Preventing Corns on Feet

Here are some tips to help you prevent corns from developing on your feet:

• Always wear clean, dry socks.
• Avoid wearing shoes indoors.
• Avoid buying shoes that do not have a natural shape.
• Do not wear shoes that are tight around your toes.
• When trying on new shoes, pay attention to how the inside seams rub against your feet when you walk.
• Buy shoes with extra padding.
• Avoid activities that cause excessive friction and pressure.
• Keep your skin moisturized.

Talk with your podiatrist about recurrence of corns.

Talking to Your Podiatrist

Here are some questions you may want to ask your podiatrist about corns on your feet:

• After treatment begins, what symptoms should I watch for that may indicate that the corn is not healing?
• What over-the-counter products will work best for me?
• I’d like you to look at my footwear and tell me if they fit properly. Can I make another appointment to bring in my shoes?
• How severe are the corns on my feet?
• What type of athletic shoes would benefit me most?
• Will the treatment cause me to miss work or school?

What To Do When You Have Itchy Feet

Authored by Dr. Matthew Garoufalis 
Reviewed by Dr. Vincent Marino

• Overview
• What Causes Itchy Feet?
• Itchy Feet Symptoms
• Diagnosing Itchy Feet
• Itchy Feet Treatment 
• Itchy Foot Products
• Talking to Your Doctor

Itchy feet can be bothersome and discomforting. They are usually the result of a fungal infection or skin condition, but many other things can lead to the itching. Itchy feet can be an indicator of an underlying condition such as eczema or athlete’s foot.

The itch can begin at any time of day or night. Many people find it easier to deal with during the day, since the brain is active and a conscious decision can be made not to scratch the itch. While we’re asleep, however, and the brain is not functioning on a conscious level, the itching can become a major problem; in our sleep, we are apt to scratch, which can lead to blisters, open sores, swelling, and redness. In general, itching occurs more during the night because of the drop in adrenaline and cortisone and the increase in histamine that occurs while we lie resting. These changes are related to the circadian rhythm of hormones in our bodies.

What Causes Itchy Feet?

The two most common causes for itchy feet are fungal infections such as athlete’s foot (tinea pedis) and skin conditions such as eczema, dermatitis, and psoriasis. Additional causes include:

• Allergies
• Irritants such as laundry detergent, soap or perfume
• Sweaty feet
• Foot rash
• Insect, tick or flea bites
• Hives
• Hookworm
• Hot feet
• Sock material
• Shoe material
• Hormonal changes, especially in pregnant women
• Poor hygiene

Washing your feet is just as important as washing your hands. Bacteria are naturally present on our skin, and there are more than 250,000 sweat glands located on each foot—and they are continuously sweating. Without soap and water, and given a warm, moist location such as in shoes and socks made of suffocating materials like nylon, the bacteria will begin to grow when mixed with sweat, causing itchy, smelly feet. There are also medical conditions such as ancylostoma duodenale that list itchy feet as a symptom. Ancylostoma duodenale is a parasitic hookworm infestation that is typically contracted by walking barefoot in damp soil. Not only does this condition make one’s feet itch, it makes the entire body itch. Talk with your Podiatrist about other medical conditions that could be causing your feet to itch.

Itchy Feet Symptoms

Itchy feet are usually an indicator of another problem, and they can also produce symptoms of their own, such as:

• Redness
• Inflammation
• Blisters or open sores
• Flaky patches
• Cracked skin
• Peeling skin
• Bleeding

Many of these symptoms arise after the person continually scratches the foot for a long time. It does not take much scratching to turn your skin red and weaken it, making it susceptible to flaking or cracking.

Diagnosing Itchy Feet

If you have itchy feet and are unaware of any problems such as infection, dry skin, or allergies, you should consider having your feet examined by a Podiatrist at Advanced Foot & Ankle Center. Fungal infections are progressive, and it could take years for additional symptoms such as yellow toenails to appear. Your podiatrist will give you a physical exam and possibly take samples of your skin or sores to test under a microscope in order to make a diagnosis. Once a diagnosis is made and the cause of the itchy feet is determined, a proper treatment plan can be created.

Itchy Feet Treatment & Prevention

Treatment for itchy feet will depend on the cause. If you have a fungal infection such as athlete’s foot, antifungal medication can be bought over the counter or prescribed by your podiatrist. If you are suffering from dry skin or a skin condition, therapeutic ointments and creams can be prescribed to fight the itch and additional symptoms such as dry skin that may be causing the itch. Often cortisone cream is used to treat itchy feet. For more severe cases an oral steroid may be used. Treatment will also involve prevention measures, including:

• Keeping feet clean at all times
• Keeping feet thoroughly dry
• Wearing clean socks and shoes
• Wearing socks and shoes made of breathable materials
• Wearing gloves and/or socks at night
• Keeping nails trimmed short and smooth
• Avoid being barefoot in public showers, locker rooms, pools or gyms
• Follow your podiatrists instructions at all times

Itchy Foot Products

Here are some of the most popular products on the market for itchy feet. You should be able to find them in your local pharmacy, drug store, grocery store, or online:

• Lotrimin Ultra Antifungal Athlete’s Foot Jock Itch Cream
• Flexitol Medicated Foot Itch Relief Cream
• Lamisil At Athlete’s Foot Cream
• Ting Athlete’s Foot and Jock Itch Cream
• Medifirst Antifungal Cream
• Tinactin Antifungal Jock Itch Cream (clinically proven to cure most athlete’s foot and ringworm)
• Natureplex 1% Clotrimazole Antifungal Athlete’s Foot Jock Itch Cream
• Canestan Duel Action Cream

If possible, talk with your podiatrist before purchasing any over-the-counter medication. Depending on the severity of your case, these over-the-counter products may not do anything for you.

Talking to Your Podiatrist

Here are some questions to ask your podiatrist about itchy feet:

• What over-the-counter products do you recommend to your patients?
• Based on my situation, do you recommend prescription strength or over-the-counter products for me?
• What type of socks and shoes will prevent the itchiness?
• What can I do to prevent myself from scratching my feet while I sleep?
• If treatment is not working, how long should I wait to schedule another appointment?
• I like to take hot showers; could that be a contributing factor?

Ganglion Cyst of the Foot

Ganglion Cyst Foot

Authored by Dr. Gregg Congdon
Reviewed by Dr. Michelle Heiring

Ganglion cysts of the foot are benign, fluid-filled, soft-tissue masses that attach to tendon sheaths or joint capsules. The fluid tends to be thick, sticky, clear, and jelly-like. It is similar to synovial fluid, which lubricates the joints and tendons. Most ganglion cysts appear on the wrist, but a significant number also occur in the foot, usually the top. The termganglion means “knot,” which describes these irregular, multi-walled, mobile masses underneath the skin. The most distinguishing feature of ganglions is their location around joints and tendons, although in rare cases they may found in bones or tendons.

The development of ganglion cysts may be rapid, or it may occur over many years. They may shrink, enlarge, or even disappear and reappear. The majority of them disappear within two years. Although not generally painful themselves, ganglion cysts may cause symptoms due to their proximity to other structures. They can be found in any age group, and women are three times more likely than men to suffer from them.

Symptoms of a Ganglion Cyst on the Foot

The first symptom will be a lump on the foot, either visual or by feel. The lump is most commonly on the top of the foot, but it can be located near any joint or tendon, and it may vary in size. Other symptoms may include:

• Burning sensation (indicating the cyst is pressing against a nerve)
• Pain (indicating the cyst is pressing on a nerve, joint, or tendon)
• Limitation of motion (the cyst is pressing against a joint or tendon)
• Skin irritation above the ganglion
• Wearing shoes is painful due to the size of the cyst

While ganglion cysts are often painless and harmless, as with any growth, you should have yours checked by your physician to rule out more serious issues.

What Causes Ganglion Cysts?

The exact cause of ganglion cysts is still unknown. The most prevalent theory involves trauma to the affected area, which may result from a single, direct incident or from chronic overuse. This results in inflammation of the associated connective tissues, which then degenerate or liquefy into “ganglionic jelly.” The remaining connective tissue forms the cystic capsule to enclose this fluid, thus creating the ganglion cyst.

Diagnosing a Ganglion Cyst on the Foot

Your doctor will ask about the history of the lump and perform a physical exam. The diagnosis may be based on appearance and feel. Sometimes a light shone through the lump can indicate whether the fluid is more liquid or solid, which further helps with the diagnosis. Additional testing may include analysis of the ganglionic fluid, x-rays and/or ultrasound. The x-rays and ultrasound may show damage to surrounding structures (tendons, joints, bones, etc.); furthermore, the ultrasound is often diagnostic for ganglions. Should these tests be inconclusive, an MRI may be ordered. Once diagnosed, a treatment plan can be created.

Ganglion Cyst Foot Treatment

Treatment of the ganglion is dependent on the symptoms you are experiencing. If you are not in pain and the cyst is small, your doctor may prefer merely to monitor the situation. If there is pain, limitation of motion, or difficulty wearing shoes, however, some treatment may be necessary.

The simplest form of treatment is aspiration (or drainage) of the ganglion. Usually the area is numbed with local anesthetic, after which a large-gauge needle is introduced to remove the fluid. Often a corticosteroid, and sometimes Hyalauroindase (a dissolving enzyme), is injected after the drainage to reduce the likelihood of recurrence. While aspiration is immediately curative, ganglion cysts do have a high rate of recurrence.

If the aspiration technique doesn’t work, surgery may be performed to excise the cyst. Depending on the size and location, this procedure may be done in the office or the hospital. It requires local anesthesia, sutures, bandaging, and possibly splinting, again depending on the size and location of the cyst. Post-operatively, rest and reduction of activities may be required. The benefit of the excision procedure is that it has a significantly higher success rate in preventing recurrence, although complications such as joint stiffness, scar formation, and infection are possible.

Home remedies seem to have little effect on ganglion cysts. Heat may reduce the size of the cyst, but only temporarily. Many home remedies can cause more harm than good, such as “Bible Therapy,” which involves taking a heavy object such as a book and smashing the cyst. Needless to say, such therapy can create complications.

Risks of Ganglion Cysts

Here are some risks of ganglion cysts or their treatments:

• Infection
• Reaction to corticosteroid
• Recurrence
  • Excision: 5 to 15 percent of the time
  • Aspiration: 50 to 70 percent of the time
• Scar at excision site
• Reduction of range of motion
• Damage to vessels or nerves after injection or excision

Talking to Your Podiatrist at Advanced Foot & Ankle Ctr.

Here are some questions to ask your Podiatrist about a ganglion cyst:

• Are there any home treatments I can use?
• Is there any way to prevent scar formation if the cyst is surgically removed?
• If my cyst is surgically removed, will you be the one performing the surgery?
• Can ganglion cysts be prevented?
  

Foot Melanoma is the Deadliest Cancer

Foot Melanoma Is The Deadliest Cancer - Routine Foot Self Exams Can Increase Early Detection, Survival

The next time you clip your toenails, take a closer look at the rest of your feet. An extra 60 seconds could save your life. 

Foot and ankle surgeons say routine self examinations of the feet are an important way to find skin cancer early, when it's easiest to cure. Half of the people who learn they have melanoma of the foot die within five years because the cancer had already spread throughout their body by the time it was diagnosed. 

Nearly 60,000 people will learn they have melanoma this year. It's not known how many of those cases will involve the foot, but more than 8,100 melanoma patients will die. nearly one death every hour.
If melanoma is detected in its earliest stages, 92 percent of patients are alive after five years. 

Unlike many other types of cancer, melanoma strikes people of all age groups, even the young. Whites are 10 times more likely to develop melanoma than blacks. But studies suggest more than half of melanoma cases in blacks involve the foot, where late diagnosis leads to a higher death rate. Routine foot self exams increase the likelihood of noticing suspicious moles, freckles or other spots. 

Various examples of melanoma on the skin of the foot.
Photo copyright ©2010 Bristow et al; licensee BioMed Central Ltd. FromPMC.

Foot and ankle surgeons recommend focusing on the three most common areas for foot melanoma: the soles, between the toes, and around or under the toenails. 

Melanoma can develop anywhere on the body including areas that receive little sun exposure, such as the feet and ankles. If a mole, freckle or spot starts to change over the course of a month and becomes asymmetrical or changes its border, color, diameter or elevation, see a doctor immediately. Those are the ABCDEs, or signs, of melanoma. 

Skin Cancers of the Feet

Skin Cancers of the Feet

What Are Skin Cancers of the Feet?

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. Frequently, individuals discover their skin cancer after unrelated ailments near the affected site.

Causes

We often view the sun's harmful rays as the primary cause of skin cancer; the condition is often found on parts of the body that receive the most sun exposure. Skin cancers of the feet, however, are more often related to viruses, exposure to chemicals, chronic inflammation or irritation, or inherited traits. Unfortunately, the skin of the feet is often overlooked during routine medical examinations, and for this reason, it important that the feet are checked regularly for abnormalities that might indicate evolving skin cancer.

Types and Symptoms

Some of the most common cancers of the feet are:

Basal Cell Carcinoma: Basal cell carcinoma frequently is seen on sun-exposed skin surfaces. With feet being significantly less exposed to the sun, it occurs there less often. This form of skin cancer is one of the least aggressive cancers in the body. It will cause local damage but only rarely spreads beyond the skin. Basal cell cancers may appear as pearly white bumps or patches that may ooze or crust and look like an open sore. On the skin of the lower legs and feet, basal cell cancers often resemble non-cancerous skin tumors or benign ulcers. 

Squamous Cell Carcinoma: Squamous cell carcinoma is the most common form of cancer on the skin of the feet. Most types of early squamous cell carcinoma are confined to the skin and do not spread. However, when advanced, some can become more aggressive and spread throughout the body. This form of cancer often begins as a small scaly bump or plaque, which may appear inflamed. Sometimes there is a history of recurrent cracking or bleeding. Occasionally it begins as a hard projecting callus-like lesion. Though squamous cell cancer is painless, it may be itchy. Squamous cell cancer may resemble a plantar wart, a fungal infection, eczema, an ulcer, or other common skin conditions of the foot.

Malignant Melanoma: Malignant melanoma is one of the deadliest skin cancers known. Non-surgical treatments are rarely effective, and many remain experimental. This type of skin cancer must be detected very early to ensure patient survival. Melanomas may occur on the skin of the feet and on occasion beneath a toenail. They are found both on the soles and on the top of the feet. As a melanoma grows and extends deeper into the skin, it becomes more serious and may spread through the body through the lymphatics and blood vessels.

Malignant melanoma has many potential appearances, leading to its nickname, “The Great Masquerader.” This skin cancer commonly begins as a small brown-black spot or bump; however, roughly one third of cases lack brown pigment and thus appear pink or red. These tumors may resemble common moles; however, close inspection will usually demonstrate asymmetry, irregular borders, alterations in color, and/or a diameter greater than 6 mm.  Melanomas may resemble benign moles, blood blisters, ingrown nails, plantar warts, ulcers caused by poor circulation, foreign bodies, or bruises. 

When to Visit a Podiatrist

Podiatrists are uniquely trained as lower extremity specialists to recognize and treat abnormal conditions on the skin of the lower legs and feet. Skin cancers affecting the feet may have a very different appearance from those arising on the rest of the body. For this reason, a podiatrist's knowledge and clinical training is of extreme importance for patients for the early detection of both benign and malignant skin tumors.

Learn the ABCDs of melanoma. If you notice a mole, bump, or patch on the skin that meets any of the following criteria, see a podiatrist immediately:

• Asymmetry - If the lesion is divided in half, the sides don't match.
• Borders - Borders look scalloped, uneven, or ragged.
• Color - There may be more than one color. These colors may have an uneven distribution.
• Diameter – The lesion is wider than a pencil eraser (greater than 6 mm).

To detect other types of skin cancer, look for spontaneous ulcers and non-healing sores, bumps that crack or bleed, nodules with rolled or “donut-shaped” edges, or scaly areas.

Diagnosis and Treatment

Your Podiatrist at Advanced Foot & Ankle Center will investigate the possibility of skin cancer both through a clinical examination and with the use of a skin biopsy. A skin biopsy is a simple procedure in which a small sample of the skin lesion is obtained and sent to a specialized laboratory where a skin pathologist will examine the tissue in greater detail. If a lesion is determined to be cancerous, your podiatrist will recommend the best course of treatment for your condition.

Prevention

Prevention of skin cancer on the feet and ankles is similar to any other body part. Limit sun exposure, and make sure to apply appropriate sunscreen when you are outdoors and your feet and ankles are exposed.

What is the Treatment for Foot Pain?

What is the treatment for foot pain?

When you first begin to notice discomfort or pain in the area, you can treat yourself with rest, ice, compression, and elevation (RICE). Over-the-counter medications may also be used to reduce discomfort and pain.Treatments are optimally directed toward the specific cause of the pain.

Rest will allow the tissues to heal by preventing any further stress to the affected area. Crutches should be used if you have difficulty putting weight on the foot. Appropriate use of commercially available ankle and foot supports may provide rest, comfort, and support to the affected area.

Ice should be applied no longer than 20 minutes. The ice may be put in a plastic bag or wrapped in a towel. Commercial ice packs are not recommended because they are usually too cold. If extreme discomfort occurs, icing should discontinue immediately.

Compression and elevation will help prevent any swelling of the affected tissues.

There are two types of over-the-counter medications that may help with the pain and swelling of foot pain. Acetaminophen (Tylenol) will help reduce the pain, while a nonsteroidal anti-inflammatory such as aspirin, ibuprofen(Motrin), or naproxen (Naprosyn) can help lessen the pain and as well as reduce the inflammatory response. Caution should be taken when using these drugs as dosage should not exceed the labeled directions.

A popular home remedy for relief of plantar fasciitis is rolling a golf ball on the ground with the bottom of the foot.

Blisters occur as a result of chafing. These "hot spots" should be attended to immediately with padding or friction reducers. If these spots progress to a blister and are unbroken, the doctor can drain them by puncturing from the side with a clean needle, and drained, the skin will act as a natural bandage and should not be trimmed away. If the skin over the blister is broken, the loose skin should be peeled back and the area should be treated as an open wound. Blisters should be covered and padded before returning to activity; in simple cases, a Band-Aid may solve the problem. If the blister is bigger, donut pads, gel pads, or commercially available blister pads may be more appropriate. To avoid blistering in the future, a generous application of petroleum jelly to the affected area can be helpful.

Medical treatment

Once the severity and cause of foot pain is determined, a course of corrective and rehabilitative actions can be started.

• Qualified Podiatristsl may use electrical medical devices such as ultrasound, various forms of electrical stimulation, LED light therapy (laser), and/or manual therapies to reduce pain and increase circulation to the area to promote healing.
• Maintenance of fitness levels via modification of activity may be prescribed.
• Substitute activities that aggravate the pain and soreness.  Running causes the body to have repetitive impact with the ground. The use of bicycling, elliptical trainers, step machines, swimming, or ski machines minimize impact and allow you to maintain and improve your fitness.
• Corrective prophylactic measures
• New shoes or the replacement of current shoe insoles
• Proper footwear fitting, including lacing and sock combinations to eliminate compression and friction issues
• Additional supports added to the shoes such as heel pads or cushions, arch supports, and various wedges to help maintain the foot in a proper position
• Athletic shoes lose the elastic properties of the soles through usage and age. A good rule of thumb is to replace your shoes every six months or more often if there is heavier usage. The use of replacement insoles can increase energy absorption and add support to the foot.
• Corrective and over-the-counter orthotics may also improve the biomechanics of the foot.
• Muscle strengthening and flexibility
• You may be given exercises to increase the strength and stability of the affected area and to correct muscles that may not be balanced.
• Exercises to increase flexibility will maintain or improve the length of a muscle. Flexibility helps to make a stronger muscle and less likely to be injured.
• Appropriate medication to control inflammation or disease-related symptoms
• In some cases, surgery may be necessary.
• Biomechanical evaluation
• Your body will create various changes in movement when you have an injury. A therapist can evaluate these changes and help you make the appropriate corrections. Prolonged, uncorrected biomechanical changes may lead to secondary mechanical changes that are painful and difficult to correct and may lead to a poor prognosis and possibly a slow or incomplete recovery from the symptoms.
• Techniques such as chi and barefoot running or using minimalist running shoes have been helpful and may help correct biomechanical problems in runners when properly implemented.
• Follow up with your Podiatrist at Advanced Foot & Ankle Center until you are better.