< Mechanical stresses of the foot | The Fundamentals of Professionalism >
  1. ekhayes Welcome New Poster


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    i just want to get an idea of what people think is the most current theory of the formation of these lesions :)
     
  2. DaVinci Well-Known Member

    I can't say I have seen anything new on this since I graduated (not that I have been exactly looking).

    I think its still:
    Aetiology: Unknown.
     
  3. There is a school of thought that porokeratosis - or seed corns if you prefer - form when eccrine sudoriparous gland ducts keratinise after the gland itself stops working. What is interesting is the pattern of lesions that occur in some patients - often circular or in a horseshoe formation around the 2nd-4th MTPj which may indicate a failure of the local sympathetic nervous system.

    Not a major problem however as they resolve fairly quickly with the use of [regular] occlusive petroleum jelly wraps.

    Mark Russell
     
  4. Donna Active Member

    Hi Mark,

    I am intrigued...

    Do you mean petroleum jelly occluded by cling wrap? How long is it applied for each time? How often would you class as regular? Is it ok to use as a self treatment for patients or supervised? Is it performed before or after scalpel debridement? How much would it slow down recurrence of the H Mille?

    Regards

    Donna ;)
     
  5. Donna

    This is the regime I use for most anhidrotic skin conditions - porokeratosis, heel fissures & etc. It may vary from patient to patient but the general aim is to rehydrate the skin and increase the elasiticity. Providing the patient maintains the treatment on a weekly basis most lesions resolve within two months. It's the water that's the really important factor - the Vaseline and Cling Film simply occludes and retains over a period of several hours.

    Make sure your patients adhere to the last bit of advice!

    Mark Russell


    1.Soak feet for 15-20 minutes in warm water then dry thoroughly, especially between toes.

    2.Apply generous layer of Vaseline (petroleum jelly), then wrap feet in cling film (or a light plastic bag).

    3.Pull over a pair of socks and leave on all night.

    4.Wash off in morning and apply a little hand cream.

    5.Repeat nightly for 7 nights then once a week thereafter (or as instructed by your podiatrist)

    ***Exercise Caution when Walking***


    PS - I have it on good authority that it's also a good cure for cracked lips. See Scene 13. http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=288
     
    Last edited: Mar 23, 2006
  6. Donna Active Member

    Thanks Mark,

    Now I just need to find a compliant patient to try it on! ;)

    Regards

    Donna
     
  7. Heather J Bassett Well-Known Member

    Hi I will need to reclassify my findings, thought porokeratosis and HMille were different keratin symptoms, my search on google didn"t help. Does every one classify these two things as being the same????
    hj
     
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