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Primary Foot Care

Primary Foot Care. Common Nail Problems. When to Refer?. Fungal Nails. Fungal Nails - Treatment. Routine Debridement Topical Agents Oral Agents. Oral Agents. Fungal Nails - Treatment. Fluconazole (Diflucan) Itraconazole (Sporanox) Ketoconazole (Nizoral) Griseofulvin (Gris-peg)

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Primary Foot Care

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  1. Primary Foot Care

  2. Common Nail Problems

  3. When to Refer?

  4. Fungal Nails

  5. Fungal Nails - Treatment • Routine Debridement • Topical Agents • Oral Agents

  6. Oral Agents Fungal Nails - Treatment • Fluconazole (Diflucan) • Itraconazole (Sporanox) • Ketoconazole (Nizoral) • Griseofulvin (Gris-peg) • Terbinafine (Lamisil)

  7. When to Refer?

  8. Pedal Skin Problems • Tinea Pedis • Verrucae • Corns & Callouses

  9. Tinea Pedis

  10. Tinea Pedis - Etiology • Dermatophytes • Trichophyton • Epidermophyton • Microsporum • Saprophytes and Yeast • Bacteria

  11. Tinea Pedis - Treatment • Topical Agents • Imidazoles: miconazole, clotrimazole, sulconazole, etc. • Others: undecylenic acid, tolnaftate • Oral Agents • Used in severe/resistant cases • Griseofulvin, ketoconazole • Fluconazole, itraconazole, terbinafine • Local Care

  12. When to Refer?

  13. Verrucae

  14. When to Refer?

  15. Corns & Callouses

  16. Corns - When to Refer? • Multiple Lesions • Multiple Digital Deformities as Cause • Rigid Digital Contractures • Ulcerative Lesion • Immediate • Definitive • Diabetics, PVD, Neuropathic

  17. Morton’s Neuroma - Etiology • Narrow Shoes (Primary Cause) • High Heels • Biomechanical (Functional) Abnormalities • Excessive pronation • Flatfoot • Hammertoes • Traumatic • Anatomic

  18. Dorsal Digital Nerves Intermetatarsal Space Interosseous Tendons Flexor Digitorum Longus Tendon Morton’s Neuroma Plantar Digital Nerves Deep Transverse Intermetatarsal Ligament

  19. Morton’s Neuroma - Symptoms • Burning • Tingling • Numbness (Usually only Subjective) • Radiating Pain into the Involved Toes • Feeling as Though “Walking on a Pea” or “Sock is Bunched Up” • Strong Desire to Stop, Remove Shoe, and Massage Forefoot

  20. When to Refer?

  21. Hammertoes -Conservative Treatment • Treat Only the Symptoms • Aperature Pads • Splints • Extra-depth Shoes • Caution When Using Acid Plasters In: • Diabetics • PVD • Neuropathic

  22. Pre-Op Post-Op

  23. Pre-Op Post-Op

  24. Hammertoes - When to Refer? • Rigid Deformities • Recurrent Ulceration • Chronic Pain in All Types of Shoes • Other Associated/Contributing Deformities • Patient No Longer Satisfied with Conservative Therapy

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