Hi all,
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First time poster here- please go easy. :eek:
I have a patient who has a very stubborn vp cluster on the plantar/lateral aspect of his heel. The cluster is around 40mm in diameter. The patient is in his early 40s, nil medial history to report and is on no meds. His neurovascular findings are all excellent.
The cluster has been gradually increasing in size for around 3 years but due to work commitments (he is a farmer) and being disheartened by previous treatments not working he has let it get rather large. Over the 3 or so years he has tried most treatment options including off the shelf topical creams, duct tape/elastiplast, cryo, offloading etc.
I was thinking he may be a candidate for a more radical treatment option of either trichchloracetic acid crystal in sal acid, OR needling until LA. I understand both have their risks and I have had some experience with both modalities BUT have not had any previous experience with such a large lesion.
Any advice would be greatly appreciated. I'm worried that 'opening up' an area of that size would be far too painful on a weight baring area even with offloading which I have discussed with patient but he is keen to get rid of it regardless.
Thank you so much for your time and input!
<
Differentiating gout,
CPPD, and non?crystal-related inflammatory arthropathies)
|
Biophysical outcome measures for evaluating normal and hyperkeratotic foot skin
>
<
Differentiating gout,
CPPD, and non?crystal-related inflammatory arthropathies)
|
Biophysical outcome measures for evaluating normal and hyperkeratotic foot skin
>
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