10/21/20161Moses Demehin, Pharm.D.PGY-1 Pharmacy Practice Resident UPMC Presbyterian Shadyside •Identify patient symptoms associated with foot disorders, warts and fungal infections•Differentiate between hard and soft exclusions for self-treatment •Establish appropriate goals of OTC therapy •Recommend appropriate nonpharmacologic and pharmacologic therapy•Provide patient education•Common minor foot disorders include •Corns and calluses •Bunions•Exercise induced foot injuries •Ingrown toenails•Hyperhidrosis•Pathophysiology•Friction and pressure increase mitotic activity of the basal cell layer leading to the migration of maturing cells through the prickle cell and granular skin layers •Migration produces a thicker stratum corneum•Clinical presentation •Corns: small raised, sharply demarcated, hyperkeratotic lesion with a central core •Calluses: indefinite borders and ranges from a few millimeters to several centimeters in diameter. Typically raised, yellow and has a normal pattern of skin ridges on its surface Coffey. Handbook 17thedition. 2012ExclusionSoftHardDiabetes mellitus, a peripheral circulatorydisease, or other medical condition thatcontraindicates use of foot care productsXLesions hemorrhaging or oozing purulentmaterialXAnatomic defect or fault in body weightdistributionXExtensive or painful, debilitatingcorn/calluses on footXProper but unsuccessful self‐medicationattemptXHistory of rheumatoid arthritis andcomplaint of painful metatarsal heads ordeviation of great toeXCoffey. Handbook 17thedition. 2012
10/21/20162•Goals: •Provide symptomatic relief •Remove corns and calluses, and•Prevent their recurrence by underlying causes •Nonpharmacologic therapy:•Daily soaking of affected area for at > 5 minutes in warm water•Cushioning pads •Eliminate pressure Coffey. Handbook 17thedition. 2012Trade NamePrimary IngredientMOADose/FrequencyDuration of TherapyCurad Mediplast®Corn, Callus & Wart RemoverSalicylic acid 40%Acts on hyperplastic keratin and causes area to swell, soften, macerate and then desquamate the affected epitheliumDaily to BIDSoft corns: 3-6 daysHard corns: 14 days Q48H NTE 5 treatments in 2 weeksFreezone®One Step Corn/Callus Remover Pads Dr. Scholl’s®CushinGel Corn/ Callus Remover Disk Daily to BIDDr. Scholl’s®Corn/Callus Remover liquid Salicylic acid 12.6%Coffey. Handbook 17thedition. 2012•Remission of corns and calluses may take several days to months •Elimination of predisposing factors is crucial to removal and prevention of recurrence •Pads and cushions help to reduce pressure and shearing associated with corn and callus development •Stop treatment and consult a PCP or podiatrist if swelling, reddening or irritation of the skin occursCoffey. Handbook 17thedition. 2012•Pathophysiology•Prolonged pressure over angulated metatarsophalengeal joint of the great toe may result in painful inflammation and swelling over the involved bony joint•Clinical presentation •Asymptomatic but can become painful •
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Salicylic acid, Human papillomavirus, callus, Terbinafine, Wart, Plantar wart