By Michael E. Edmonds, Alethea V. M. Foster, Lee Sanders
3rd writer, Lee. J. Sanders, is the dept of Veterans Affairs scientific middle, Lebanon, PA. bargains useful and scientific recommendation at the administration of long term foot difficulties in individuals with diabetes. Discusses prognosis and remedy, either clinical and surgical. fine quality colour photographs illustrated some of the problems. DNLM: Diabetic Foot--diagnosis.
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Additional resources for A Practical Manual of Diabetic Foot Care
Reduction of smoking Smoking is avery significant risk factor for peripheral vascular disease. Clear, unequivocal advice should be given to stop smoking, but it is a very difficult habit to break. Enrolment in a smokers’ clinic programme may help the patient to give up. Health-care professionals cannot afford to ignore the problem of smoking in diabetic patients and should strongly encourage them to stop. Treatment should still be offered to patients who continue to smoke, but advice to stop or reduce the amount of tobacco consumed should be frequent and unequivocal.
Other causes of onychocryptosis include pressure on the side of the nail from tight shoes or tight socks, antithrombotic stockings or support hose, or a trauma to the side of the nail, as when the toe is stubbed. Some teenagers with a very thin nail plate and a fleshy nail sulcus are particularly prone to onychocryptosis. Treatment of onychocryptosis involves removal of the offending splinter (nail spicule) (Fig. 5a,b), and the ragged edge of the nail is then filed smooth with a Black's file (a small file specially designed to fit into the sulcus and under the nail).
Differential diagnosis was necrosis caused by infection or purely by hydrostatic pressure from a collection of blood under the nail plate. Systemic antibiotics were prescribed. The necrotic area gradually dried, demarcated and healed. When the new nail plate grew back it was onychogryphotic. Lesions under the nail These can be due to: • Haematoma • Necrosis • Melanoma • Exostosis. Subungual haematoma. This follows a trauma to the nail, when blood collects under the nail plate causing red, purple or black discolouration.