Foot, Ankle & Lower Leg Center: June 2012

Tuesday, June 26, 2012

Sunscreen on Your Feet

Published by: American College of Foot and Ankle Surgeons

Many don’t realize skin cancer can occur on the feet from unprotected sun exposure, and overlook applying sunscreen to the area

Doctors urge sunscreen use and exams to prevent skin cancer on feet

When at the pool or lake we all lather up with sun screen to protect our skin from the harmful rays of the sun. But do we remember to apply sunscreen to our feet?

Many don’t realize skin cancer can occur on the feet from unprotected sun exposure, and overlook applying sunscreen to the area. But, physicians from the American College of Foot and Ankle Surgeons warn skin cancer of the foot is prevalent and can even be fatal if not caught early.

While all types of skin cancer, including squamous cell and basal cell carcinoma, can be found on the foot, the most common is the most serious form, melanoma. Symptoms can be as subtle as an abnormal-looking mole or freckle found anywhere on the foot, and often go unnoticed without routine foot exams.

According to foot and ankle surgeon Thanh Dinh, DPM, FACFAS, early diagnosis is key to effective treatment for the condition. But because people aren’t looking for the early warning signs or taking the same precautions they do for other areas of the body, often times skin cancer in this region is not diagnosed until later stages.

“I advise my patients to regularly inspect their feet, including the soles, in between their toes and even under their toenails, for any changing moles or spots and to have any suspicious areas promptly examined by a foot and ankle specialist,” Dr. Dinh explains.

Please call the Foot, Ankle & Lower Leg Center office in Las Vegas and the Henderson area anytime @702-878-2455 between Monday – Friday (9am to 5pm) and we would be happy to set up an appointment for you. Please visit our website @ www.FallCenter.com.

When pain or injury occurs, you deserve highly personalized treatment using the most advanced techniques. At the Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality care. Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide comprehensive solutions for all types of foot and ankle problems.

Your quality care begins the minute you arrive, as our staff greets you by name and answers your questions. Our team of foot and ankle specialists will inspire your confidence and their genuine warmth and compassion will earn your trust.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays. Your treatment plan is designed to resolve your condition without surgery whenever possible. When surgery is needed, your feet are in the hands of leading physicians with expertise in the latest minimally invasive techniques. As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs, Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following “Center of Excellence” treatment programs: Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Performance Center.

Sunday, June 24, 2012

Pedicure or Pedicurse? Proceed With Caution

8 ways to watch out for your tootsies at your next pedicure

Posted by: U.S. News & World Report

Short of going barefoot, nothing conjures the free spirit of summer like sandals. But given the way we treat our feet—whether we're running marathons or home from work and in shoes that pinch, press, and blister—it's no wonder they need grooming before flaunting.

Fact: Your feet require some TLC. More facts: Salon pedicures can be rife with risks. In fact, some foot baths might as well be renamed cesspools, hotbeds of germs that can lead to bacterial, viral, and fungal infection. Not to sound biblical, but customers have gone home with boils. Unsanitary tools aren't much better, and can spread infections such as hepatitis.

So the next time you treat your toes to a pedicure, follow these tips for feet as happy as they are healthy.

1. Shun the razor. Never, ever let a nail technician put a razor to your feet and be wary of doing so yourself. The practice can lead to permanent damage along with upping your risk of infection through cuts and the possible transference of blood between customers. Callouses provide cushioning between you and the ground, and removing too much of the toughened skin can make it hurt to walk. A much gentler option is to soften your feet with a pumice stone, foot file, or exfoliating scrub, according to the American Podiatric Medical Association (APMA).

2. Don't cut corners. Go for a shape that's square, not oval. Round toenails are more likely to dig into skin, causing painful ingrown toenails, says Hillary Brenner, a Manhattan-based podiatric surgeon and an APMA spokesperson.

3. Beware of the foot bath. "Do not use the foot spa if you are not sure it is disinfected and safe to use," warn the Environmental Protection Agency and Centers for Disease Control and Prevention in a fact sheet on preventing infections from salon foot spas. To reduce the risk of infection from bacteria that can grow in foot spas, salons should use an EPA-registered hospital disinfectant between each customer, and nightly, and according to the directions, which usually call for 10 minutes of disinfection, according to the government groups.

For your part, hold off on the foot bath if you have any cuts, scrapes, scabs, bruises, or open sores on your legs or feet as broken skin eases the passage of germs into your body. The EPA and CDC also include bug bites on this list, which seems to ensure no one could ever possibly be fit for a pedicure, given the coinciding seasons of pedicures and bugs. Also, skip the pre-pedicure shave to avoid causing any nicks. The APMA suggests scheduling your spa pedicure early in the morning, since "salon foot baths are typically cleanest earlier in the day." Brenner advises patronizing nail salons that use disposable plastic bins inside the foot bath to lower your risk of infection.

4. Don't feed your feet to the fish. The trend of using so-called "doctor fish" to eat up dead skin on people's feet is one you might want to skip—if your state hasn't already banned the practice. A letter published this month in Emerging Infectious Diseases found that these fish, imported from Asia to salons in the United Kingdom, carried a range of potentially dangerous bacteria.

5. Keep away from the cuticle. "The cuticle is the nail's protective barrier and should not be pushed back, which can damage it and increase the risk of infection," according to the American Academy of Dermatology, which warns that buffing nails too intensely can harm your cuticles as well.

6. Use your own tools. Because germs can spread through tools that aren't properly cleaned, it's best to bring your own. That includes emery boards, which can't be sterilized due to their porous nature. Pedicure tools can be found for a variety of prices in most beauty supply stores. Some salons even sell individual kits they then keep on hand for regular customers.

7. Skip the salon and see a podiatrist. A doctor's office doesn't exude the pampered feel of a salon. But that may be changing. Podiatrists are increasingly offering medical pedicures, which include paraffin wax for dunking and softening feet along with chemical-free, anti-fungal nail polish, Brenner says. These treatments come with a cost—anywhere from $80 to $150, says Brenner, who notes an alternative could be a simple callous removal. Inspired by the results of her own facial peels, Brenner has begun offering her patients chemical foot peels, which shed the top layer of skin to reveal smooth feet.

8. Do it yourself. For an at-home pedicure treatment, Brenner advises soaking your feet for 10 to 15 minutes two to three times a week in an Epsom salt solution, made of two cups of Epsom salt per gallon of tepid water. Follow that with a foot scrub (Brenner likes the apricot scrub by St. Ives) and a thick coating of moisturizer like shea butter. At that point, you've done most of the leg work, so to speak, and you can leave the polish to the professionals.

Warning signs. Infections from the nail salon can often look like bug bites, which worsen and enlarge and can cause pus and scarring, according to the EPA and CDC. Yellowed nails or scaling skin around the base of the foot indicate fungal infections, while anything "red and angry looking" is likely a bacterial infection, Brenner says. Determining the existence of hepatitis requires a blood test.

Thursday, June 21, 2012

Health Tip: Help Prevent Warts on the Feet

Don't walk barefoot

Posted on HealthDay News

(HealthDay News) -- Plantar warts -- warts that specifically affect the feet -- are caused by viruses and can be quite painful. Children and teens seem to get them more often than adults.

The American Podiatric Medical Association offers this advice for how to prevent warts on the feet:

· Unless you're strolling on a sandy beach, don't walk barefoot.

· Put on a fresh pair of socks each day, and alternate shoes each day.

· Make sure your feet are always dry and clean.

· Inspect your child's feet regularly.

· Do not touch warts on another person or on another part of the body.

· Pay attention to unusual growths on the skin. Seek prompt medical attention if you find any.

Wednesday, June 20, 2012

All Toes on Deck

Tips for Protecting Feet from the Heat

Published by: APMA (American Podiatric Medical Association Inc.)

One perk of a beach-bound vacation is knowing that instead of snow soaking through your Choos or having your feet feeling toasty in sweaty Uggs, you can lounge happily with your toes dangling in the warm weather, shoe-free with the sand at your feet. But alas, the dream does come with its own set of tootsie troubles. "Even if you are just lying still on your back soaking up the rays, your feet are still vulnerable," says American Podiatric Medical Association member Dr. Jane Andersen. "You can seriously sunburn your feet and no matter how upscale your hotel, athlete’s foot can lurk in all public pool areas."

Wouldn’t you rather spend time collecting sea shells than doctor’s bills? No worries. There are ways to prevent these future foot predicaments so you can go back to your sun-kissed dreams and enjoy a liberated foot experience.

1. Limit walking barefoot as it exposes feet to sunburn, as well as plantar warts, athlete’s foot, ringworm, and other infections and also increases risk of injury to your feet.

2. Wear shoes or flip-flops around the pool, to the beach, in the locker room and even on the carpeting or in the bathroom of your hotel room to prevent injuries and limit the likelihood of contracting any bacterial infections.

3. Remember to apply sunscreen all over your feet, especially the tops and fronts of ankles, and don’t forget to reapply after you’ve been in the water.

4. Stay hydrated by drinking plenty of water throughout the day. This will not only help with overall health, but will also minimize any foot swelling caused by the heat.

5. Keep blood flowing with periodic ankle flexes, toe wiggles, and calf stretches.

6. Some activities at the beach, lake or river may require different types of footwear to be worn so be sure to ask the contact at each activity if specific shoes are needed. To be safe, always pack an extra pair of sneakers or protective water shoes. If your shoes will be getting wet, they should be dried out completely before your next wearing to prevent bacteria or fungus from growing.

7. If you injure your foot or ankle while on vacation, seek professional medical attention from a podiatric physician. Many often only contact a doctor when something is broken or sprained, but a podiatrist can begin treating your ailment immediately while you’re away from home. Use our Find a Podiatrist tool to get treatment wherever your travels take you!

8. In case of minor foot problems, be prepared with the following on-the-go foot gear:

§ Flip flops – for the pool, spa, hotel room, and airport security check points

§ Sterile bandages – for covering minor cuts and scrapes

§ Antibiotic cream – to treat any skin injury

§ Emollient-enriched cream – to hydrate feet

§ Blister pads or moleskin – to protect against blisters

§ Motrin or Advil (anti-inflammatory) – to ease tired, swollen feet

§ Toenail clippers – to keep toenails trimmed

§ Emery board – to smooth rough edges or broken nails

§ Pumice stone – to soften callused skin

§ Sunscreen – to protect against the scorching sun

§ Aloe vera or Silvadene cream – to relieve sunburns

Wednesday, June 13, 2012

Skin Cancers of the Feet

Published by American Podiatric Medical Association

What Are Skin Cancers of the Feet?

Skin cancer can develop anywhere on the body, including in the lower extremities. Skin cancers of the feet have several features in common. Most are painless, and often there is a history of recurrent cracking, bleeding, or ulceration. Frequently, individuals discover their skin cancer after unrelated ailments near the affected site.

Causes

We often view the sun’s harmful rays as the primary cause of skin cancer; the condition is often found on parts of the body that receive the most sun exposure. Skin cancers of the feet, however, are more often related to viruses, exposure to chemicals, chronic inflammation or irritation, or inherited traits. Unfortunately, the skin of the feet is often overlooked during routine medical examinations, and for this reason, it important that the feet are checked regularly for abnormalities that might indicate evolving skin cancer.

Types and Symptoms

Some of the most common cancers of the feet are:

Basal Cell Carcinoma: Basal cell carcinoma frequently is seen on sun-exposed skin surfaces. With feet being significantly less exposed to the sun, it occurs there less often. This form of skin cancer is one of the least aggressive cancers in the body. It will cause local damage but only rarely spreads beyond the skin. Basal cell cancers may appear as pearly white bumps or patches that may ooze or crust and look like an open sore. On the skin of the lower legs and feet, basal cell cancers often resemble non-cancerous skin tumors or benign ulcers.

Squamous Cell Carcinoma: Squamous cell carcinoma is the most common form of cancer on the skin of the feet. Most types of early squamous cell carcinoma are confined to the skin and do not spread. However, when advanced, some can become more aggressive and spread throughout the body. This form of cancer often begins as a small scaly bump or plaque, which may appear inflamed. Sometimes there is a history of recurrent cracking or bleeding. Occasionally it begins as a hard projecting callus-like lesion. Though squamous cell cancer is painless, it may be itchy. Squamous cell cancer may resemble a plantar wart, a fungal infection, eczema, an ulcer, or other common skin conditions of the foot.

Malignant Melanoma: Malignant melanoma is one of the deadliest skin cancers known. Non-surgical treatments are rarely effective, and many remain experimental. This type of skin cancer must be detected very early to ensure patient survival. Melanomas may occur on the skin of the feet and on occasion beneath a toenail. They are found both on the soles and on the top of the feet. As a melanoma grows and extends deeper into the skin, it becomes more serious and may spread through the body through the lymphatics and blood vessels.

Malignant melanoma has many potential appearances, leading to its nickname, “The Great Masquerader.” This skin cancer commonly begins as a small brown-black spot or bump; however, roughly one third of cases lack brown pigment and thus appear pink or red. These tumors may resemble common moles; however, close inspection will usually demonstrate asymmetry, irregular borders, alterations in color, and/or a diameter greater than 6 mm. Melanomas may resemble benign moles, blood blisters, ingrown nails, plantar warts, ulcers caused by poor circulation, foreign bodies, or bruises.

When to Visit a Podiatrist

Podiatrists are uniquely trained as lower extremity specialists to recognize and treat abnormal conditions on the skin of the lower legs and feet. Skin cancers affecting the feet may have a very different appearance from those arising on the rest of the body. For this reason, a podiatrist’s knowledge and clinical training is of extreme importance for patients for the early detection of both benign and malignant skin tumors.

Learn the ABCDs of melanoma. If you notice a mole, bump, or patch on the skin that meets any of the following criteria, see a podiatrist immediately:

§ Asymmetry - If the lesion is divided in half, the sides don’t match.

§ Borders - Borders look scalloped, uneven, or ragged.

§ Color - There may be more than one color. These colors may have an uneven distribution.

§ Diameter – The lesion is wider than a pencil eraser (greater than 6 mm).

To detect other types of skin cancer, look for spontaneous ulcers and non-healing sores, bumps that crack or bleed, nodules with rolled or “donut-shaped” edges, or scaly areas.

Diagnosis and Treatment

Your podiatrist will investigate the possibility of skin cancer both through a clinical examination and with the use of a skin biopsy. A skin biopsy is a simple procedure in which a small sample of the skin lesion is obtained and sent to a specialized laboratory where a skin pathologist will examine the tissue in greater detail. If a lesion is determined to be cancerous, your podiatrist will recommend the best course of treatment for your condition.

Prevention

Prevention of skin cancer on the feet and ankles is similar to any other body part. Limit sun exposure, and make sure to apply appropriate sunscreen when you are outdoors and your feet and ankles are exposed.

Tuesday, June 5, 2012

Flip-flop fail: Reasons to avoid the shoes this summer

Posted on: WTOV-TV (Health News)

The Reef Arch-1 is one of the flip-flops that made the list of approved flip-flops by the American Podiatric Medical Association. (Courtesy Reef)

WASHINGTON - Flip-flops are part of the summer uniform. But there are good reasons to avoid them. "Flip-flops are great for our business as podiatrists, but they are very bad for people's feet," says podiatrist Dr. Arnold Ravick of Capital Podiatry in D.C.

The cheap, thin flip-flops sold at discount stores are the culprits. They can cause blistering because they are so rubbery -- and that's just the beginning. "They bend and fold so there is no control," Ravick says. "People fall out of them. People injure themselves. They are not made for a lot of walking and they are not made for support."

He says the shoes are made to be worn on a hot pool deck or in a gym shower, and nothing more. Ravick says he has seen injuries where people try to mow the lawn wearing flip-flops "and roll over their foot with a lawn mower or have a rock or a piece of glass hit them."

Accidents on Metro are far more common. "People in Metro get their flip-flops and toes caught in the escalator. That happens usually in the summer a lot," he says. And then there are the nagging injuries that come from walking long distances in flip-flops. Ravick says tendinitis is common.

"The other thing you see with flip-flops is your toes buckle or pull a lot," he says. "That is how you keep the shoe on. That is how you make your foot go forward, by gripping of the toes, and that leads to hammer toes and bunions and things like that."

Ravick says while some flip-flops may be cheap, people pay in the long run with injuries. He says there are alternatives that cost more, but are definitely worth it.

For a list of sandals and flip-flops approved by the American Podiatric Medical Association, follow this link.

When pain or injury occurs, you deserve highly personalized treatment using the most advanced techniques. At Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality care. Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide comprehensive solutions for all types of foot and ankle problems.