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Case Study Assessment At A Birmingham Podiatry Clinic

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Case study assessment.

A 47-year-old female patient attends a Birmingham podiatry clinic with callus and heloma durum presenting on the plantar surface of the 1st MTPJ of the left foot. The patient is generally fit and well, and requires routine treatment.

To enable the podiatrist to treat callus and corn, they must first understand the biological process that leads to the pathology. Callus, or hyperkeratosis, a diffuse area of relatively even thickness (Lorimer et al.1997), is formed from hypertrophy of the superficial layer of the epidermis, the stratum corneum, and reduced desquamation rate causing the skin to increase layers and harden (Fig 1). Mechanical stresses on the skin, for example the compression and friction from poorly
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Fluid building up in the tissues caused by an inflammation response, triggered by the repeated stresses on the tissues, can lead to maceration of the deeper tissues, resulting in wounds and ulcers. Especially in patients with limited healing due to circulation conditions and diabetes, or those suffering peripheral neuropathy (Fig 3)

Assessments

A number of assessments are carried out before diagnosing and treating the patient.

Vascular Assessment

Test carried out

Right foot

Left foot

Pulses palpable

Yes

Yes

Doppler pulses

Dorsalis Pedis

Triphasic

Triphasic

Posterior Tibial

Triphasic

Triphasic

Cappillary refill time

2 seconds

2 seconds

Skin Assessment

Healthy

Healthy

Nail Assessment

Healthy

Healthy

Temperature gradient

Warm to cool

Warm to cool

Hair present

Yes on legs and all toes

Yes on legs and all toes

Other skin signs and

symptoms:

Oedema (Non pitting)

No

No

Oedema (pitting)

No

No

Intermittent Claudication

No

No

Rest pain

No

No

Neurological Assessment

Test carried
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