Treating idiopathic interdigital maceration

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Does anyone have any ideas on how best to manage idiopathic interdigital maceration?

I usually use surgical spirits and apply using a cotton wool applicator, but even twice daily applications seem to be ineffective in most patients.

Your help would be greatly appreciated.

Ryan.

 

Try Povidine Iodine in alcohol. Very drying and will help control any underlying TP

 

non-pharmacologically, why not non-adherent dressings applied by using a rectangle of nad with a 'dumb-bell shaped' non-allergenic tape fixed across the nad forming a 'cross' >>> result a double nad layer, tres absorbent ... use this on myself every tp infection .. 2-3 days (redress after shower) and voila ...... big negative of course is pt has to be mobile enough to apply dressings

 

Have you tried 25% AgN03? Applied fortnightly and debrided..... I have found this very effective.

 

Hi Ryan,

I use surical spirit also but make sure your patient doesn't put his shoes / socks on staight away as there's no chance of the spirit evaporating. If necessary, wegde the digits to enable evaporation - doesn't take long.

Rebecca

 

Ryan

A light dusting of talc in between the toes helps. The main function of the powder is not absorption of the fluids (although that may take place ) but the creation of a friction free plane between the digits to allow them to rub together without creating tensile stresses. Spirit based antiseptics will work but can sting if there are fissures present and water based antispetics would be a painless alternative. Usually by working in-between the toes allows sufficient airing to facilitate evaporation and when good foot hygiene is encouraged and folllowed the vast majority of clients benefit. Atomisers of perfume or spirit allow clients unable to bend to apply astringents but cottom wool buds are more useful.

How are you doing anyway ?

Cameron

 

Whilst working in Birmingham, I had a west indian patient with a severe case of interdigital maceration. I suggested the daily use of surgical spirit. On her return several weeks later, I was pleased to note the complete resolution of the problem. My patient then reported that she had used strong Jamaican rum rather than surgical spirit.......hmmmmmmmmm!

 

Iodine will be helpful,anything that dries.
Why do you say it is idiopathic?Have you taken a culture(bacterial or fungal)?

 

I advise my patients zinc oxide [sudocrem for babies bums or good old Aussie sunscreen].They are similar surfaces-moist and close together.The zinc oxide is applied stiffly to allow a reduction in friction.By the end of the day it has become a powder.The interdigital space soon becomes dry.This is also great for oedematous digits especially in hospital/NH environments.The usual treatment is lint or CW in these environments which can become quite stiff.
One of my patients,a large diabetic Scotsman buys rather cheaply [I did say he was Scots!] the cologne testers from the pharmacy-works,easy to apply with the spray and his feet always smell sweet!

 

Just a thought

Idiopathic "a disease or condition the cause of which is not known or that arises spontaneously".

If the cause is unknown how can anyone recommend an effective treatment that is more than just a randon suggestion?

Dave