April 5, 2015

Foot Care and Prevent Amputations – Part 1

Rather than rewrite blogs – here is a list of blogs that are applicable to foot care and a few of the problems.

I know people are tired of hearing about managing diabetes, but as with all complications, the best solution to prevent complications is keeping blood glucose levels as near normal as possible. With your feet and lower limbs, this is extremely important and then, in addition, if you have neuropathy, daily inspection for sores, cracks, and ulcers becomes a necessity. Taking care of these early and working with your doctor and possibly a podiatrist to recommend treatments is wise.

Another problem that is often overlooked is this. Onychomycosis is a fungal infection of the fingernails or toenails. The actual infection is of the bed of the nail and of the plate under the surface of the nail.

Onychomycosis is the most common of all diseases of the nails in adults. In North America, the incidence falls roughly between 2-13%. The incidence of onychomycosis is also greater in older adults, and up to 90% of the elderly may be affected. Men are more commonly infected than women.

Individuals who are especially susceptible include those with chronic diseases such as diabetes and circulatory problems and those with diseases that suppress the immune system. Other risk factors include a family history, previous trauma to the nails, warm climate, and occlusive or tight footwear.

Onychomycosis is caused by three types of fungi, called:
  1. Dermatophytes
  2. Yeasts
  3. Nondermatophyte molds

Fungi are simple parasitic plant organisms that do not need sunlight to grow. Toenails are especially susceptible because fungi prefer dark damp places. Swimming pools, locker rooms, and showers typically harbor fungi. Risk factors include:
  • Chronic diseases such as diabetes
  • Problems with the circulatory system
  • Immune deficiency disease
  • A history of athlete's foot
  • Excess perspiration are also risk factors

Onychomycosis can be present for years without causing pain or disturbing symptoms. Typically, the nail becomes thicker and changes to a yellowish-brown. Foul smelling debris may collect under the nail. The infection can spread to the surrounding nails and even the skin.

To make a diagnosis of onychomycosis, the doctor must collect a specimen of the nail in which infection is suspected. A clipping is taken from the nail plate, and a sample of the debris from underneath the nail bed is also taken, usually with a sharp curette. Debris from the nail surface may also be taken. These will be sent for microscopic analysis to a laboratory, as well as cultured to determine what types of fungus are growing there.

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