A Practical Manual of Diabetic Foot Care - download pdf or read online

By Michael E. Edmonds, Alethea V. M. Foster, Lee Sanders

ISBN-10: 1405107154

ISBN-13: 9781405107150

3rd writer, Lee. J. Sanders, is the dep. of Veterans Affairs clinical heart, Lebanon, PA. deals functional and scientific suggestion at the administration of long term foot difficulties in individuals with diabetes. Discusses prognosis and remedy, either clinical and surgical. top quality colour images illustrated a few of the problems. DNLM: Diabetic Foot--diagnosis.

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Extra resources for A Practical Manual of Diabetic Foot Care

Sample text

D) (d) A fibrous plate has replaced the troublesome nail 6 months later. 22 Chapter 2 Fig. 7 Distal and lateral onychomycosis. sulcus they can accumulate, causing pain and pressure. The nail sulcus is gently cleared with a Black's file. In severe cases, nail avulsion with phenolization of the nail bed, as shown in Fig. 6 can provide a permanent solution. Nail infections Onychomycosis (fungal nail). When fungal infection invades the nail plate it first causes white or yellowish discolouration of a patch of nail, which subsequently becomes thickened and friable.

Treatment should continue until a new nail has formed, which may take up to 12 months. If systemic treatment is undertaken it is important to be aware of the possible side-effects of therapy. • Terbinafine 250 mg daily for 3 months is the drug of choice for fungal nail infections. Rarely, it can cause liver toxicity • Itraconazole 200 mg daily for 3 months or as Sporanox Pulse 200 mg bd for 7 days and subsequent courses repeated after a 21-day interval. Itraconazole has been associated with liver damage and should not be given to patients with a history of liver disease.

Malignant melanoma may also present as a discoloured area under the nail plate. Irregular discolouration of the nail bed and plate and progressive destruction of nail are seen. Some melanomas are not associated with pigment (Fig. 9). Patients should be referred urgently to the dermatologist. Subungual exostosis. An acutely painful cherry red spot develops under the nail plate. A lateral X-ray reveals bony outgrowth of the distal phalanx. The treatment is surgical. Fungal infections (tinea pedis) These can present in several ways: • Dry, scaly plantar, often in a 'moccasin-like' distribution • Acute vesicular • Interdigital, with moist, cracked areas which may be sore, itchy and sometimes malodorous, and are associated with whitish, rubbery, macerated skin, and can undergo erosion.

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A Practical Manual of Diabetic Foot Care by Michael E. Edmonds, Alethea V. M. Foster, Lee Sanders


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