Are your “ugly” toenails embarrassing you?

Do your thick, discolored, unsightly toenails cause you too much embarassment? Do you find yourself refusing to wear your sandals in the summer? Are you nervous that the infection will spread? Don’t worry, we are here to help!

Fungal toenails, or onychomycosis, are one of the most common conditions a podiatrist sees. Fungus is a naturally occurring component on the skin and nails, especially in the foot. If ignored, the fungus can cause an infection. Infection is especially prone when there has been a trauma to the toenail.

Are you unsure if your toenail is fungal? If your toenail appears thickened, yellowish, and crumble, chances are you have a fungal infection. People who have some immune compromise, such as diabetics, are more likely candidates for fungal infections. These people are also at risk for more severe infections if the fungal infection is ignored.

How do you treat fungal infections? There are many over-the-counter medications and preparations available, as well as many popular home remedies, which provide no cure. Fortunately, the podiatrists here at Shenandoah Valley Podiatry can evaluate and treat fungal infections with various medications that provide complete cures. No more “ugly” toenails for you!

Whether it be a prescription topical medication or an oral medication, a cure is possible. Remember, the nail is slow to clear so make your appointment today. We will cure you of your infection AND your embarrassment!

Custom Orthotics Save Giraffe's Life

Humans aren't the only creatures that need care for their feet.

Hope, a baby giraffe born at the Topeka Zoo this July, has been given another chance at a full life, thanks to some clever work with some makeshift "custom orthotics". The giraffe was born with her fetlock joints bent at 90 degrees and dislocated.

Dr. Joseph P. Kamer, a local small animal practitioner, acted quickly at the time of the giraffe's birth and straightened the animal's joints. He put her rear hooves into hard casts within two hours of her birth. After consulting withe veterinarians at the zoo as well as some large animal specialists, Dr. Kamer decided to take the conservative approach and designed a corrective shoe of his own custom design for baby Hope.

The wooden shoes were glued to Hope's hooves using methylmethacrylate cement and polyethylene mesh reinforcement. Dr. Kramer fashioned artificial tendons out of nylon rope to resemble the flexor tendons and attached them to the shoe, then ran them along the leg in plastic tubing.

As the baby giraffe grew, the casts and shoes were changed to accommodate her size, and by late September she was out of the casts and no longer needed support for her left leg. "The animal can run - full bore - with these shoes on," said Dr. Kamer. "As long as I can keep the shoes on this animal for the next several months, then I think that's key." He is guardedly optimistic about Hope's chances of survival and adds that he hopes these podiatric techniques will help other giraffes that suffer from similar deformities.

Special thanks to a wonderful patient of ours for pointing out this article from JAVMA (Journal of the American Veterinary Medical Association) by R. Scott Nolen! Article is from Vol. 237, No.9 Page 1002 on November 1, 2010. Photo courtesy of Topeka Zoo.

Stasis Dermatitis

Stasis dermatitis is an inflammatory skin disease that occurs on the lower extremities and is chronic in nature.

This condition is commonly seen in patients with chronic venous insufficiency. Venous insufficiency occurs as a result of loss of valvular function. Stasis dermatitis typically affects middle-aged and elderly patients and may be a precursor to lower leg venous ulcers.


History/Physical:

• The appearance of reddish-brown skin may represent an early sign of stasis dermatitis
• Stasis dermatitis is associated with brown deposits in the skin called hemosiderin
• The inner ankle is frequently involved
• Lower extremity edema (swelling) is often present
• The patient with stasis dermatitis may experience mild itching, pain, or even cramping
• Stasis dermatitis may present as red, scaling plaques with drainage, crusting, and possible superficial ulceration
  

Differential diagnosis:

• Eczema - A skin condition that may include dryness, rash, and inflammation
• Dermatitis (various types)
• Cellulitis - A skin infection
• Necrobiosis Lipoidica - A necrotizing skin condition
• Tinea Pedis - An infection of the skin caused by a fungus
  

Work-up:

• Venous doppler study may be used to reveal a deep venous thrombosis or valve damage
• Skin biopsy of stasis dermatitis may be indicated in rare instances.

Treatment:

• Compression therapy - Specialized compression stockings that have a controlled gradient of pressure. Compression can also be accomplished by the use of elastic wraps and Unna boots.
• Elevation of lower extremities frequently
  

Topicals:

• Corticosteroids - To reduce inflammation and itching
• Wet to damp gauze dressings for weeping lesions
• Open lesions are treated with topical antibiotics
• Leg ulcerations or lesions with with coexisting skin infections may also be treated with oral or IV antibiotics by the physician