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I have noticed some yellowish crumbly skin on the feet of patients with fungal nail infection close to the affected nail. It is very easy to remove this with a drop of 5% hydrogen peroxide and a blunt instrument like a probe and I have been wondering if it the result of inefficient hygiene on part of the patient.
Sometimes there is darker patches of flat dead skin which can be removed easily in the same way.

Do other practitioners say anything to the patient about this? Do you ask them about their feet washing habits?

I would be interested in your experiences.

 

Always hard with no photo, but from the description this sounds to me more like the skin I see on patients where the natural skin sloughing via everyday friction does not take place. Usually fragile elderly folk, who are lying sitting a lot and who also struggle to wash their feet and rely on carers to do, possibly not as often as may need.

 

Advice on hygiene always a highly sensitive area. I try to avoid the hygiene aspect altogether and suggest soaking the feet in warm water a couple of times a week would be relaxing and good for the health of the skin. Lots of advice on careful drying between toes etc. also takes the emphasis away from the cleansing element. Very difficult if the pt relies completely on outside help but a little suggestion that the helper could supply a bowl of warm water whilst they carry on with other duties may be something not previously thought of.