Even Your Feet Can Get Skin Cancer

Skin cancer in the lower extremity may have a very different appearance from those arising on the rest of the body.  Podiatrists are uniquely trained as lower extremity specialists to recognize and treat abnormal conditions as they present themselves on the skin of the lower legs and feet. 

Because of this, a podiatrist’s knowledge and clinical training is of extreme importance for patients in the early detection of both benign and malignant skin tumors. Some of the common attributes of cancerous lesions include:

·       Asymmetry – If divided in half, the sides will not match

·       Borders – They look scalloped, uneven or ragged

·       Color – They may have more than one color which may be unevenly distributed

·       Diameter – They can appear wider than a pencil eraser

For other types of skin cancer, look for spontaneous ulcers and non-healing sores, bumps that crack or bleed, nodules with rolled or donut shaped edges, or discrete scaly areas.  If you notice a mole, bump or patch on the skin of a friend or family member that meets any of these criteria, encourage them to see a podiatrist immediately. 

What are the Types of Skin Cancer of the Feet?

Skin cancers of the feet have several features in common with most being painless and a history of recurrent cracking, bleeding, or ulceration.  Frequently individuals discover their skin cancer after unrelated ailments near the affected site.  Some of the most common cancers of the lower extremity are:

Basal Cell Carcinoma: Frequently seen on sun-exposed skin surfaces, and with feet being significantly less exposed to the sun, Basal cell carcinoma occurs there less often.  This form of skin cancer is one of the least aggressive cancers in the body.  It will cause local damage, but only rarely spreads beyond the skin.  Basal cell cancers may appear as pearly white bumps or patches which may ooze or crust being similar in appearance to an open sore.  On the skin of the lower legs and feet, basal cell cancers often resemble non-cancerous skin tumors or benign ulcers.

Squamous Cell Carcinoma: This is the most common form of cancer on the skin of feet and is most often confined to the skin and do not spread, similar to basal cell carcinoma.  When advanced, some can become more aggressive and spread throughout the body.  It is important to bring attention to any new developments on your feet to your podiatrist for early diagnosis.  Squamous cell carcinoma often begins as a small scaly bump or plaque, which may appear inflamed.  Sometimes there is a history of recurrent cracking or bleeding as well.  Occasionally they begin as a hard projecting callus-like lesion.  Though painless, squamous cell carcinoma may be itchy.  It may also resemble a plantar wart, a fungal infection, eczema, an ulcer, or other common dermatological conditions of the foot. 

Malignant Melanoma: This is one of the deadliest skin cancers known and nonsurgical treatments are rarely effective, remaining experimental.  This type of skin cancer must be detected very early to ensure patient survival.  Melanomas may occur on the skin of the feet and on occasion beneath a toenail.  They are found both on the soles and on the tops of your feet.  As a melanoma grows and extends deeper into the skin, it becomes more serious and may spread throughout the body through the lymphatics and blood vessels.

Prevention is Key

The best way to prevent skin cancer is to avoid sunbathing and tanning salons.  Sunscreen should be used frequently and before any prolonged exposure to the sun.  All skin lesions should be checked and if changes are detected in a mole or skin lesion, if you are even mildly suspicious about the appearance of one, you should contact your podiatrist immediately. 

People who have had melanoma once are at an increased risk for developing it again.  You should watch your skin carefully and take note of any unusual marks or moles, especially ones that change in shape, size, or color.  Protecting your skin from additional sun damage is very important, as well as scheduling an appointment with your podiatrist.

You change as you age, but so do your feet

If you want to age gracefully, it is also important to maintain foot health in order to help you properly move about.  Mobility is important for gaining the independence that is needed to help our aging population remain active and healthy.  Foot ailments make it difficult and sometimes impossible to work or participate in social activities.  Just as you need to prepare a newborn’s health by visiting doctors, you need to maintain proper foot health to prevent various foot ailments that could disrupt your life.

Foot problems can be prevented

There are more than 300 different foot ailments and some can even be traced back to heredity, with the majority of foot pain being treated by your podiatrist to eliminate any problems.  For the aging population, most of these foot ailments stem from the cumulative years of neglect or abuse, but even people in their retirement years, foot problems can be treated successfully, and pain relieved.

As a person ages, their feet tend to spread and lose the fatty pads that cushion the bottom of the feet.  Additional weight can also affect the bone and ligament structure. Older people, consequently, should have their feet measured for shoe sizes more frequently, rather than assuming that their shoe sizes remain constant. Observing preventive foot health care has many benefits for you, the patient.  Preventive measures can increase comfort, limit the possibility of additional medical problems, reduce the chances of hospitalization because of infection, and lessen requirements for other institutional care.

Remember these health tips for feet

When it comes to your feet, it is important to take extra precautions and properly care for your feet.  Some common foot health tips include:

• Properly fitted shoes are essential; an astonishing number of people wear shoes that
  don’t fit right, and cause serious foot problems.
• Bathe your feet daily in lukewarm (not hot) water, using a mild soap, preferably one
  containing moisturizers, or use a moisturizer separately.
• Trim or file your toenails straight across.
• Pantyhose or stockings should be of the correct size and preferably free of seams.
• A shoe with a firm sole and soft upper is best for daily activities.
• Shop for shoes in the afternoon; feet tend to swell during the day.
• Walking is the best exercise for your feet.
• Do not wear constricting garters or tie your stockings in knots.
• Never cut corns and calluses with a razor, pocket knife, or other such instrument;
  use over-the-counter foot products only with the advice of a podiatrist.
• Inspect your feet every day or have someone do this for you. If you notice any redness,
  swelling, cracks in the skin, or sores, consult your podiatrist.
• Have your feet examined by a DPM at least twice a year.

Contact Dr. Mark Forman at our Scottsdale, AZ office for more information on how you can better prepare your feet for optimal health as you age. And remember, pain is not something you should live with. 

Attention Diabetics: Take Care of Your Feet

 With damage to your nervous system caused by diabetes, you might not be able to feel your feet properly.  Normal sweat secretion and oil production that lubricates the skin of the foot is often impaired and, as a result, this can lead to an abnormal pressure on the skin, bones, and joints of the foot during walking and other activities. 

This can even lead to the breakdown of the skin on the foot, causing sores to develop. If you have diabetes, it is important to take proper precautions to prevent foot problems before they occur, recognize problems early and seek the right treatment from your podiatrist when a problem does happen.

Complications with Your Feet and Diabetes

There are several risk factors that can increase your chances of developing foot problems and diabetic infections in the legs and feet with poorly fitting shoes as one of the biggest culprits of diabetic foot complications. 

If you suffer from any of the following symptoms, it is important to find new proper fitting shoes immediately:

·      Red spots

·      Sore spots

·      Blisters

·      Corns

·      Calluses

·      Consistent pain when wearing shoes

And if you have common foot abnormalities such as flat feet, bunions, or hammertoes, prescription shoes or orthotics from your podiatrist might be necessary to further protect your feet from other damage.

Poor Circulation and Nerve Damage

People who have long-standing or poorly controlled diabetes are also at risk for having damage to the nerves in their feet, which is known in the medical community as peripheral neuropathy.  If you have nerve damage, you may not be able to feel your feet normally and you may also be unable to sense the position of your feet and toes while walking and balancing, which can cause even more harm to your feet. 

Normal nerves allow people to sense if their shoes are too tight or if their shoes are rubbing on the feet too much.  With diabetes, you may not be able to properly sense minor injuries, such as cuts, scrapes and blisters—all signs of abnormal wear, tear, and foot strain. The following can also compromise the health of your feet:

·      Poor circulation

·      Trauma to the foot

·      Infections

·      Smoking

Diabetes can be extremely dangerous to your feet, so take precautions now.  You can avoid serious problems such as losing a toe, foot, or leg by following proper prevention techniques offered by your podiatrist. And remember, prevention is the key to saving your feet and eliminating pain.

Let the Healing Begin: How to Address Heel Pain

The good news about heel pain is that if it is addressed appropriately and with regularity it can be resolved within months. The first step in proper heel care is rest. Whenever possible do your best to avoid walking or standing for long periods of time. However, rest does not mean keeping your feet immobile. Stretching your feet  and calves is key to reducing heel issues, while simultaneously improving flexibility in the affected foot. While lying in your bed, loop a towel around the affected foot. Keeping your knee straight, pull back on your toes with the towel. Repeat three times on each foot even if the other is not causing you discomfort. To address your calves stand on a stair with your heels hanging of the step with feet slightly apart. You may want to hold the railing for support while lowering your heels until you feel your calves tighten, then hold for forty seconds. Repeat this stretch up to six times twice a day.

Reducing the inflammation in the affected heel will help to relieve pain. Taking a nonsteroidal anti-inflammatory drug like ibuprofen will aid in the reduction of both swelling and discomfort. If you would rather a non medicinal option try wrapping an ice pack in a towel before applying it to the affected area for five to ten minutes.

Additionally you should think about the type of footwear that you are choosing for your feet. Flat-soled shoes should be avoided as they offer no support and could potentially increase your already existing heel issues. Aim for footwear that allows for cushion below your heel and provides a fair amount of support to the arches of your feet. You may also wish to add orthoses to your shoes. These are insoles that fit inside your shoe to support your foot and allow your heel to recover.

If your heel pain persists for a number of weeks without improvement see a podiatrist for further consultation. They will be able to address your specific needs more accurately.

How to Keep Shoe Inserts & Orthotics Fresh

Shoe inserts and orthotics can provide you with many benefits such as cushioning your step, supporting your arches, and alleviating foot and leg pain. Podiatrists prescribe orthotics to treat a variety of foot issues such as: plantar fasciitis, bursitis, tendinitis, and foot ulcers.  Inserts and orthotics have been shown in clinical research to decrease foot pain and to improve foot function.

Let's be honest though, shoe inserts come with their own set of problems.  It is natural that overtime your orthotics will smell over time if you do not make an effort to keep them smelling fresh.

Tips for insert/ orthotic care:

• Try not to get to them too wet (especially foam or cloth covered ones)
• If wetness occurs remove from shoes immediately
• If you are concerned that they have come in contact with water, pat them dry with a towel to remove and surface moisture and leave them in a room with good ventilation
• Lay orthotics flat to dry
• Allow ample drying time, inserts can need up to several days depending on what material they are made of
• If you leave them in your shoes to dry it may result in an insert or orthotic that is less able to perform

Cleaning and washing:

Use a mild soap or detergent with lukewarm water to wash your inserts. Be sure not to let them absorb too much water by soaking them. If you have a stain that is difficult to remove it is recommended that you scrub just that area with a soft bristle toothbrush to spot-treat your orthotic. After giving them a good rinse to remove excess dirt and cleaning products allow them to dry completely. Never machine wash or dry your inserts, this will destroy the integrity of their structure.

Replacement:

The expected lifetime of an insert depends on how much you use and wear yours. Every three to nine months you should be thinking about getting new insoles.

How to Avoid Infections at the Nail Salon

First rule to remember is that not all nail salons are created equal and therefore should be chosen very carefully. Make sure that you find a salon that has obvious cleaning procedures in place between clients and where the staff routinely sterilizes their instruments. Do not feel bad for setting high standards about hygienic practices when deciding on a salon, this will enable you to truly relax and not have to worry while you are being pampered. Here are a few more tips to follow to ensure a pleasant visit without any unwelcome outcomes.

1. Bring your own instruments- This allows you to be sure of how the instruments are maintained and cleaned therefore lowering the risk of infection. Check with your chosen salon first to make sure that they are aware of your preference to do so.
2. Avoid Cuts- If your skin has an opening like a cut or scratch of any kind, it is not a good time to attend a nail salon. Your skin is your primary barrier that stops bacteria from getting into your bloodstream. You should also be cautious of shaving your legs right before getting a pedicure for the same reasons.
3. Defend your cuticles- Your cuticles are meant to prevent bacteria from getting underneath the skin by your nail bed. Pedicurist will push back and trim this skin away thus opening your toes up to infection. Just simply ask them to leave your cuticles alone. This will eliminate another opportunity for bacteria to get in.

Diabetic Foot Care 101

Diabetes can cause a variety of issues for your feet. In addition to seeing your foot doctor regularly and making sure that your blood levels are under control it is very important that you pay attention to even the smallest signs of a foot issue. This will allow you to stop something minimal like a blister from becoming an infection or worse something bigger.

Follow these tips to fend off serious foot problems.

• Daily inspections- Keep an eye out for swelling, redness, cuts, blisters or nail issues. Remember to examine the bottom of your feet too. You may want to use a magnifying hand mirror to help you see better. Call your doctor if you notice anything out of the ordinary or concerning
• Proper cleaning- Wash your feet daily in lukewarm water using a soft sponge or washcloth. Dry by patting your feet not rubbing and be sure to dry thoroughly between the toes.
• Moisturize- To prevent itching or cracking moisturize daily. However, refrain from using moisturizer between your toes as you do not want to encourage fungal infection.
• Trimmed Nails- Try to cut your toenails straight across, but not too short, this will help to prevent ingrown nails.
• Appropriate socks- Always wear clean, dry socks. You may want to try socks made specifically for diabetes patients since these have no elastic tops, go above the ankle, have extra cushioning and are made to wick away moisture. If you experience excessive sweating you may want to use an antiperspirant on the soles of your feet.
• Cover your feet- Never walk around barefoot, even at home.
• Warm and Dry- Wear warm socks in the winter and avoid getting your feet wet in the snow or rain. If your feet are cold at night wear socks to bed, but never use a heating pad or hot water bottle.