The Sole of My Foot Is Abnormally Thick!

Have you noticed that the sole of your foot is abnormally thick and almost looks like reptile scales? What you likely have is one of a variety of palmoplantar keratodermas, a heterogeneous group of disorders characterized by an abnormal thickening of skin on either the palms or soles of the feet.

There are three types of patterns of palmoplantar keratodermas, which include:

*Diffuse

• Diffuse palmoplantar keratoderma is characterized by thick, even, and symmetric hyperkeratosis over the whole of the sole. They are present at birth or during the first few months of life. 
• Diffuse epidermolytic palmoplantar keratoderma is one of the most common patterns of this condition. This too is evident at birth and is characterized by demarcated symmetric thickening of the soles, with a "dirty" snakeskin appearance.
• Diffuse nonepidermolytic palmoplantar keratoderma is an inherited autosomal dominant condition, present at birth, and is characterized by well-demarcated, symmetric keratoses, and a "waxy" appearance.

*Focal

• Focal palmoplantar keratoderma is characterized by large, compact masses of keratin which develop at sites with recurrent friction. The pattern of calluses may be discoid or linear.
• Focal palmoplantar keratoderma with oral mucosal hyperkeratosis is an autosomal dominant keratoderma that represents an overlap with pachyonychia congenita type 1 without the typical nail involvement. 

*Punctate

• Punctate palmoplantar keratoderma is characterized by tiny "raindrop" keratoses which involve the palmoplantar surface, but may be restricted in their distribution.

*Ungrouped

• Palmoplantar keratoderma and spastic paraplegia is an autosomal dominant or x-linked dominant condition that begins in early childhood with thick keratoderma over the soles.
• Palmoplantar keratoderma of Sybert is characterized by a glove-and-stocking distribution with severe symmetric involvement of the whole surface and is extremely rare. 
• Striate palmoplantar keratoderma involves the soles at birth or during the first few years of life. 

My Fifth Toe Is Constricted!

Ainhum is a painful constriction of the base of the fifth toe, which is typically followed by autoamputation several years later. It largely affects black people living in West Africa, South America, and India. In Nigeria, it is so common it affects 1.7 in every 1,000. In tropic and subtropic zones, it affects between 0.015 and 2.0 percent of the population. The average age for the patient is 38, but affects those between 20 and 50 years old. The youngest ever affected was seven years of age. It is more common in men than women and is often familial.
In the African Yorub language, ainhum means "to saw or file" and in Brazilian dialects it means "fissure". The exact cause of ainhum is unknown and it not caused by infection, parasites, fungi, bacteria, virus, and is not related to an injury. Doctors speculate that walking barefoot as a child may bring on this deformity, but ainhum also occurs in patients who have never walked barefoot. Since ainhum has been reported to occur within families, race and genetics may be one component. It has been linked to inadequate posterior tibial artery circulation and the absence of a plantar arch.
What is known as a groove will form on the lower and internal side of the base of the fifth toe, usually along the plantar digital fold. Over time, the groove will become deeper and more circular. The rate at which this condition spread varies, and may progress to a full circle within a few months or take many years. In roughly 75 percent of patients both feet are affected, though not necessarily to the same degree. There has been no case where it begins on another toe, but occasionally the third or fourth toes are affected. The distal part of the toe will begin to swell due to lymphatic edema distal and look like a small potato. When the groove deepens, compression of nerves, tendons, and vessels occurs and the bone will be absorbed by pressure. The toe's connection to the foot will become increasingly slender and will spontaneously fall off without bleeding. It usually takes about five years for autoamputation to occur.
About 78 percent of those affected have pain, which increases with gradual pressure
Little can be done for those with ainhum. Incisions across the groove have proven ineffective. Excision of the groove followed by a z-plasty can relieve pain and prevent amputation in Grade 1 and Grade 2 lesions. For Grade 3 lesions disarticulating the metatarsophalangeal joint has helped. Corticosteroid injections are sometimes helpful.
To prevent ainhum, avoid walking barefoot.
Reference: Wikipedia
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

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NFL Dreams Put On Hold Because Of A Bunion

Monday night Virginia Union athlete Kentrell Harris said that a bunion has put his NFL dreams on hold.

That's right. A bunion.
Harris is a 6-foot-4, 263 pound defensive end who had 6.5 sacks as a senior last year at Union. He was not selected during the NFL draft last month, but agreed to terms on a contract offer with the Oakland Raiders following the draft. When he arrived at rookie camp last week, his plans hit a snag.
The Raiders noticed Harris's bunion. "They already knew about it," said Harris. "But they looked at it, and they said to go ahead and get the surgery to fix it and they'd bring me back."
Harris played last year with the bunion and thought he would be fine playing in the NFL. "I only missed one game. It didn't get too bad, but sometimes, it gets to a point where I can't put a shoe on," Harris said.
Harris will have surgery on the bunion tomorrow, and was told rehab can take from four to six months. This is not Harris's first time dealing with a bunion- he had surgery to correct a bunion on his right foot during his freshman year, and the recovery time was much quicker than the anticipated time.
"I'm hoping this one won't take as long as they say, so I can get back out there. It is real frustrating. You get a chance to do something you have wanted to do your whole life, and then you have a setback like this," Harris commented.
Harris was just one of two Division II players asked to play in the NFLPA Collegiate Bowl in January in Los Angeles.
Reference: Daytona Beach News-Journal
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

What Can I Expect With Hammertoe Surgery?

As much as some patients like to try to avoid it, surgery is sometimes the only option to remedy those painful

hammertoes. Fortunately, this is one of the most common procedures we as podiatrists do and patients have an excellent recovery rate.
Before your surgery, make sure you have scheduled time off. While you will likely not require the full six weeks off, take as much time as you need until you feel comfortable. Your normal routine will be interrupted and things will take longer to accomplish, or may not get done at all, so expect more time to do tasks.
Hammertoe surgery can be done on an outpatient basis in our office or a surgery center using a local anesthetic, sometimes combined with sedation. The surgery takes about 15 minutes to perform. Up to four small incisions are made and the tendons are rebalanced around the toe so that it no longer curls. Patients can usually walk immediately after the surgery wearing a special surgical shoe. Minimal or no pain medication is needed following the surgery.
Icing and elevation of the foot is recommended during the first week following the procedure to prevent excessive swelling and to promote healing. It is also important that the dressing be kept clean and dry to prevent infection. Two weeks after the surgery, the sutures are removed and a wide athletic shoe can replace the post-operative surgical shoes. Patients can then gradually increase their walking and other physical activities.
Keep your bandages on as long as your podiatrist recommends and try not to get them wet. We sell in our offices a bag that goes over your foot and makes showering and bathing more convenient. Your podiatrist will tell you to lay off the high heels and other shoes for a bit, or even completely, until you are recovered. Hammertoes may come back on their own, based on your foot mechanics and structure, so there's no need in speeding up the process with impractical shoes. And no one wants to have surgery again!
If you're an athlete, take your time getting back into your routine. When you feel pain in the surgical area, stop your activity immediately. You wouldn't want to undo all the good work you've done!
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

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I Have A Hard Lump On Top Of My Foot

It's likely you've heard of ganglion cysts, soft, squishy lumps that appear on your feet. But maybe you've

noticed on the top of your foot a hard, bony bump. That certainly doesn't sound like it's a ganglion cyst, does it?
Because it's not! So what is this hard bump then? It's called a saddle bone deformity, or a metatarsal cuneiform exostosis. You're probably thinking to yourself, "But I've never ridden a horse before or come anywhere near a saddle! So how did I get this deformity?"
This deformity gets its name from where it appears on the foot. That fancy medical name tells us that it's on the metatarsals, the long bones that connect to our toes; cuneiforms are joints at the base of the metatarsal at midfoot; exostosis is a bony growth. So, we get the saddle name because this bony growth "saddles" the peak of the arch.
So how did you get it? Do you have high arches? Those with high arches are prone to this deformity, as well

as those with poor foot mechanics. If you've had an injury to this area before, you foot may develop the deformity. Finally, if the cuneiform joint moves around a lot, the bone may have formed to stop the joint from moving.
The bone buildup of the saddle bone deformity is typically not painful. However, it is the complications caused by the condition that make it uncomfortable. You'll find it difficult to put on shoes. During the summer, when you're likely to have open-toed shoes on, you'll feel it less, but with cooler weather and closed-toe shoes, your foot will hurt. This is because the shoe not only presses down on the bony bump, but also the peroneal tendon below. You may experience arch pain in your first and second toes.
To tell if you have a saddle bone deformity, try the Tinel's sign. Take your index and middle fingers and lightly tap the bump. If you have the deformity, you'll feel a tingling sensation around the top of your foot or in your toes. This is because of the pressure on the peroneal nerve.
If you're not experiencing a lot of pain, I would recommend changing your shoes to ones that do not rub or irritate your feet. However, if you are experiencing a lot of pain, your podiatrist will recommend removing the bony growth. It's a procedure that lasts less than one hour and you'll be able to put pressure on your foot immediately, which is unlike most foot surgeries. It will take up to six weeks to heal, but you'll feel better than new afterward!
Reference: eHow and Healing Feet.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

Related articles

• Trevor's Disease
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• I Have A Toe That Is WAY Larger Than The Others!
• Have Limited Ankle Motion? It Could Be Equinus
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• My Baby's Toe Curls- Is That Normal?
• Role Of Vitamin D In Bunions
• Questions To Ask Before Foot Surgery