The foot is the most important organ of us that carries the whole load of the body and enables us to walk, and is a mechanical wonder. The foot is mainly subject to orthopedics, but it also related to many skin and nail diseases. Warts and calluses on the feet make walking difficult due to pain, whereas thickenings called keratoderma are resistant to treatment and constitute a serious problem as genetic diseases as well as acquired diseases such as psoriasis, fungal diseases or eczema diseases. Nail diseases appear as nail thickenings and color changes again due to fungal diseases, eczema diseases or psoriasis. The detachment of the nail from the nail bed, i.e. onycholysis, may be seen in peripheral circulatory disorders or thyroid diseases.
We learn most of our knowledge about foot health and care from our experience on diabetic foot care. The bones, vessels and nerves become stiff in diabetic foot.
In foot bones, osteomyelitis may be seen, which can be so severe that amputation of the respective foot is required. A little wound between toes may in fact be an osteomyelitis wound expanding towards bone like an iceberg. We can catch the onset of, and treat, osteomyelitis, if we get suspicious of such wounds and have a foot radiograph.
In some cases, pulse in the foot dorsum may not be taken. In such a case, a diagnosis of peripheral circulatory disorder may be made if we have a colored arterial doppler test. Peripheral circulatory disorder is mostly seen in diabetic patients, and rarely in other patients. It may lead to thickening of toe nails, and skin wounds.
An another problem that may occur in the diabetic feet is nerve stiffness. It initially causes loss of sensation. Accordingly, the patient, with eyes closed, may not detect the skin sites we have touched with cotton. In such cases, a callous ulcer may be observed in the patient, especially on the heel zone. It is refractory to treatment, but can be treated with medicines such as amitriptyline.