Nicholas Campitelli, DPM | Akron Podiatrist | Foot and Ankle Surgeon

The Foot Doc Blog – Leading Blog on foot and ankle pain

Providing information on foot, toes, and ankle pain or deformities. Questions? Please ask them in the comments section below. Check out our Youtube and Instagram sites as well.
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Many people think the black tiny dots on a plantar wart are the “seeds” or viral particles present within the wart. They’re actually blood vessels within the wart. Plantar warts are extremely vascular and contain very tiny blood vessels or capillaries. The end of the capillaries extend to the surface of the wart and will “rupture” and cause micro bleeding which then dries resulting int he brownish or black looking dots on the wart. So, they are not “SEEDS” or “VIRAL” particles as you may have been told!!

Small capillaries seen within the plantar wart


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Athletes foot infections are a fungal infections of the skin on the feet that causes severe itching and dry flaky skin to occur. There are two types of athletes foot infections. One that involves the skin on the entire sole of the foot, and the other which involves the web spaces between the toes. The condition occurs more commonly when the foot is exposed moist environments such as from sweating in your shoes or if your socks become wet from environmental conditions. Fungus tends to grow in warm, dark, and moist environments and our socks and shoes can often created this ideal situation.

Fungus infections of the foot will often present with dry, flaking, and itchy skin with small red pimples or pustules than can sometimes appear. It will occur in what is referred to as a moccasin like distribution involving the sole of the foot. As previously mentioned, the condition can sometimes only effect the skin between the toes where one will see what is described as white and macerated tissue in the web spaces. This can often by overlooked and not noticed as initially it is not symptomatic. It is frequently caused by not drying well between the toes after bathing or showering. If this type of athletes foot infection is left untreated it can lead to a secondary bacterial infection from bacteria entering the cracks in the skin. This can become a medical emergency if one develops cellulitis or skin infection from the bacteria and may require hospitalization.

It is important to treat athletes foot infections when they occur as to avoid leading to more serious chronic infections which are difficult to manage. Prevention is often the best treatment by controlling the warm, dark moist environments that lead to the infection. When the dry and itching skin is present, it is crucial to see a podiatrist to begin a prescription antifungal to fix the problem.


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Many people do not realize that skin cancer can occur on the foot. While it is rare, I do see it in my office. I do my best to educate my patients on what to look for, and explain that there is only one person who can tell if it is skin cancer – that person is a pathologist. You need to look at the cells under a microscope to determine if it is malignant, or cancerous.

Watch the video below to hear Dr. Campitelli discuss skin cancer on the foot:

 

There are four major things we look at to help determine if it needs biopsied. They are easily remembered by the acronym ABCD’s of skin cancer.

A – Asymmetry   

B – Border

C- Color

D – Diameter

Asymmetry – If you were to draw a line through the skin lesion, the sides should look the same.

Border – The borders should be regular and not jagged or irregular.

Color – The color should be regular and equal throughout

Diameter – The diameter or size of the lesion should be no larger than that of a pencil eraser.


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Broken toes are extremely common and can be very painful.  The most common way to break a toe involves tripping over an object or accidentally kicking a piece of furniture.  Many patients present to my office with a broken toe that occurred by kicking the bedpost in the middle of the night while getting on to use the bathroom, or by catching their pinky toe on table or chair causing the toe to fracture and dislocate.

While many people think there is “nothing you can do for a broken toe”, this is not always true.  If one of the smaller toes is fractured and dislocated, it is important to have it reduced or put back into place to allow for proper healing and to maintain an anatomically straight toe.   The only way to accurately diagnose a toe fracture is by getting an x-ray.  Just because you are able to still ”walk” is not justification for the bone not being fractured!

If the toe is fracture and dislocated, it can be easily reduced in the office by numbing the toe and putting in back into place.  More severe toe fractures will sometimes need to be surgically aligned and repaired.

If the big toe is injured this can be more severe and should definitely be x-rayed and examined for a fracture.  Fractures of the big toe can lead to chronic pain and arthritis if left untreated.


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Ankle pain can be very difficult for a patient to describe to their physician.   It is also very difficult for general practitioners to adequately diagnose  ankle arthritis if they are not proficient in performing an ankle and foot examination.  Ankle arthritis will cause pain with dorsiflexion (moving foot upwards) and plantar flexion (moving foot downwards)  due to the bone spurs that form around the ankle joint.  The more severe the arthritis becomes, the more cartilage will erode and you will end up with “bone on bone”.  When cartilage is destroyed, it cannot be “repaired” and bone articulating on bone will create more pain and inflammation.  The longer this occurs the more irreversible the damage to the joint becomes.

Normal ankle joint

Arthritic ankle joint

Early treatment can consist of cortisone injections into the joint to reduce the soft tissue inflammation that occurs in the initial stages of arthritis.  If injections fail and the condition continues to worsen, ankle arthroscopy to clean out the soft tissue inflammation and synovitis as well as any bony fragments that may be within the joint.

When conservative treatment fails, fusing the ankle joint is the next step.  This is performed to stop motion to the ankle joint and reduce pain.  While one would think the motion is needed to walk normal, pain from the grinding and limited mobility will be worse in regards to trying to walk normal.  Many patients resume normal walking after the joint is fused compared to how they were walking prior to the surgery with pain and limping from the arthritis.

Fusion of arthritic ankle joint


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A bunion is a dislocated big toe joint that results in the head of the metatarsal becoming prominent appearing as bump on inside of the big toe.

While shoes and activity can aggravate a bunion, the cause is mostly genetic. So if your mom or dad had a bunion that’s most likely where yours came from.

Initial treatment consists of wearing wider shoes to help reduce pressure on the bump and toe spacers to realign the big toe while walking. Bunion splints can realign the toe while wearing it but the joint will return to it’s dislocated state when the splint is removed. A splint can NOT fix a bunion.

The only way to reduce a bunion deformity is through surgical correction. This involves cutting the metatarsal bone to realign the joint which reduces the bump. Depending on the type of procedure performed the recovery period can be 3-6 weeks or 6-9 weeks.

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9318 ST RT 43, Streetsboro, OH

2660 West Market Street, Fairlawn, OH

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