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Does anyone have any information regarding people who smoke and the incidence of intractable plantar keratomas? :eek: I have heard there is an increased incidence but have not read any article supporting this. If so, would stopping smoking help alleviate them in any way? Any other methods for treatment of these nasty fellows besides regular debridemant and deflective padding?
I would be interested to hear anything about them.

 

I would like to know where you heard that from :confused:
I have never heard anything remotely close to that.

 

IPK & Smoking

The dermatologic & surgical literature have for many years described the negative effect on skin health and healing in people who smoke. My understanding is that a link bewteen IPK and smoking has been established (unfortunately I do not have the references to hand).

Clinically for some time I have refused to peform operative procedures for IPK if the individual is a smoker - the failure rate is too high. Interestingly I have observed that the worst IPK cases almost always effect heavy smokers.
For what it is worth I have also noted that when I have advised ceasation of smoking prior to any surgery (and the patient has complied) the IPK has improved or disappeared.

Best treatment for these horrid lesions may be to educate on evils of smoking.

Mark Gilheany

 

Smoking and IPK

There is some literature on the effects of smoking and skin physiology, but nothing that I am aware of relating directly to IPK's. Of interest though - I have seen many patients with Plantar Palmar Keratoderma (PPK) and for whats its worth - ancedotally, the worst cases have been smokers. Also I had a couple of patients who did improve following cessation although no where near a "cure".

As the previous posting said. best keep off the tobacco!

 

Anecdotally, I also recall a pt with severe IPKs who failed miserably to respond to conservative Rx. 6 months after smoking cessation, his lesions completely resolved, and he vowed never to smoke again as his symptoms had cause him much suffering. I also agree, that the worst IPKs appear in the smoking population.

No references though.

Regards

 

Thankyou for the replies. Another good reason to let go of the horrid stuff. How many reasons do people need to give up tobacco? Okay this is not
antismoking site, I know, but I will certainly be passing on that info. to 2 people I have in mind. I'll let you know in 6 months!!!!!

 

This thread has been inactive for a while but I thought I would try to re-ignite it. I have a patient whom I believe has painful Intractable Plantar Keratomas related to smoking, present for around 6 months. The patient quit smoking after 20 years and then resumed after 6 months. A week after the resumption of smoking 2 distinct Heloma-durum-like lesions appeared on her feet. Enucleating these lesions results in no improvement of symptoms. The patient has been convinced to quit smoking. I have been told there are some articles relating to this however I have been unable to find them. If anyone knows of any reference looking at the link it would be greatly appreciated. As would any advice on treatment aside from padding and enucleation.

 

Hi Podpop,

An aside, I have always wondered whether Thyroid effects nails and plantar type corns! I have seen an improvement in such nails and corns when Thyroxine has been altered.

Another observation has been that there appears to be similarity between Thyroid and smoking in the thinness and condition of the feet but I have never seen a study on it.

Could smoking equal thyroid being effect I wonder???

Regards,

Colin.

 

_________________________________
Hi Podpup (Got it right this time!),

A late PS. for Heloma-durum, corns to you, I have always used the gouge rather than the flat blade but you have to be careful whilst digging for victory these days, you might strike oil! The President of the USA. doesn't like it!

Colin.

 

I too am interested to read any publications on this topic.

I have a patient that comes in every 5-6 weeks to have her ipk enucleated.
she also suffers from emphysema, but has never smoked a day in her life. I wonder if there is any correlation?

Molly

 

I have been in practice for over thirty years and I have seen four or five patients, mostly male, who have suffered severe neuro vascular plantar corns over periods of up to twenty five years, which have resolved within months of stopping smoking. In fact I've intended to write an article about this phenomenon , but never did get around to it!