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What are Foot Lesions?

A foot lesion is an abnormal change in an area of skin on the foot. It may be caused by infection, injury or abnormal growth of tissue. Foot lesions are commonly seen in diabetic patients due to nerve damage and poor circulation.

Types of Foot Lesions

There are different types of foot lesions and they can be broadly classified as benign (non-cancerous) or malignant (cancerous). Benign lesions such as calluses, corns, and warts remain confined to the region and do not spread. Malignant lesions show changes in growth and appearance and may spread to other parts of the body.

Common foot lesions include:

Calluses: These are areas of hard skin formation that usually occur under the foot due to poorly-fitting shoes or uneven distribution of body weight.

Corns: Corns are areas of hard skin that may develop on or in between the toes on the bony areas due to pressure applied by footwear.

Blisters: Repeated injury from ill-fitting footwear can cause fluid-filled bumps called blisters to develop. They can also be caused by infections.

Foot ulcers: These lesions are open sores that are slow to heal and are commonly seen in diabetic patients and those with poor circulation. Infection of foot ulcers is common. These lesions can be benign or malignant.

Athlete’s foot: This is an infection caused by a fungus. It causes redness, itching and cracking of the skin of the foot.

Plantar warts: Warts are lesions caused by a virus that affects the outer layer of the skin. Plantar warts are similar to calluses but have pinholes or black spots in the center. They usually form on the heel or ball of the foot and may grow in clusters.

Hand Foot and Mouth Disease: This is a viral infection characterized by red lesions on the soles of the feet, the palms of the hands, and in the mouth. It is usually seen in young children and accompanied by fever and sore throat.

Cellulitis: This is a serious bacterial infection that can spread rapidly and requires urgent care. The lesion is formed on the foot due to entry of bacteria through the skin.

Foot lumps: Soft tissue masses can develop on the foot from nerve, fat, muscle, or vascular tissue. Bony overgrowths from the foot joints can also form foot lumps. Some of these masses are painful and can affect function.

Causes of Foot Lesions

There are various causes of foot lesions but the most common include:

  • Poor blood circulation
  • Diabetes
  • Bacterial infection
  • Genetic factors
  • Inflammatory disease
  • Poorly-fitting shoes
  • Skin infections
  • Smoking
  • Usage of certain medications
  • Excess pressure applied on certain parts of the foot
  • Kidney failure

Symptoms of Foot Lesions

Symptoms associated with foot lesions vary depending on the type of lesion and may include:

  • Swelling in the foot
  • Pain
  • Pus formation
  • Numbness
  • Itching
  • Dryness
  • Gangrene (color change in skin due to low blood circulation)
  • Foul odor

Diagnosis of Foot Lesions

It is important to have a suspicious foot lesion evaluated. Diagnosis is done by examining the lesion and performing various tests that may include:

  • Assessing your blood sugar level
  • Testing sensation in your feet
  • Performing a tissue biopsy where a part of the affected tissue is obtained for examination in the laboratory.
  • Swabbing the lesion for analysis
  • X-rays to identify any damage to the bones

Treatment for Foot Lesions

Treatment is mainly focused on healing the lesion, managing any underlying condition, and reducing pain. An individualized treatment plan is adopted based on the characteristics of the lesion and your general health. Treatment methods include:

  • Antibiotics/Antifungals: To treat any bacterial or fungal infection
  • Topical medicines: Topical wound care medications to provide relief from pain, itching, and swelling.
  • Dressing of wound: This may include antimicrobial, composite dressings that protect the lesion from further infections
  • Special footwear: To relieve pressure on the lesions

Surgery may be performed to debride (clean) or excise (cut out) lesions, improve circulation and to treat lesions that affect the bones. Treatment for cancerous lesions can vary depending on how far the cancer has spread. Surgical excision may be effective in eradicating the cancer in the early stages.

Prevention of Foot Lesions

Proper foot care helps in preventing foot lesions and other foot-related problems, especially in diabetic patients. If you have diabetes, you are advised to:

  • Maintain normal blood sugar levels
  • Wash your feet daily with warm water and soap
  • Never walk barefoot, and always wear closed-toed footwear
  • Perform regular foot exercises for proper blood circulation
  • Maintain a healthy diet and keep your body weight ideal
  • Never treat corns, calluses, or blisters by yourself
  • American Orthopaedic Society for Sports Medicine
  • American Association for Hand Surgery
  • American Academy Of Orthopaedic Surgeons
  • The American Board of Pediatrics
  • North American Spine Society
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