Time to discuss a clinical topic Section

Rarer nail issues reviewed in this week’s blog from consultingfootpain

Nail pain following total ablation surgery with phenol

Removal of total nail plates can lead to delayed healing. We warn patients that 6 weeks is not unusual and can last longer. Phenol, better known as carbolic acid and smelling like a strong TCP, can be absorbed deeper into toe tissue and may even irritate bone. Hundred of thousands of these procedures are carried out each year in the UK so it is a safe procedure. If you suffer from ongoing pain this may be due to periosteal (bone lining) inflammation. Foot specialists with surgical knowledge should be consulted if things do not improve after three months. Initial treatment with Flamazine is recommended.

Nail bed cancer. Keeping a watchful eye

This is a very rare condition but a patient presented with continual bleeding of the nail bed having lost her nail. She was 57 years old and found this most inconvenient. Biopsy at my clinic at Spire Little Aston Hospital confirmed a squamous cell carcinoma. This is not that usual on the foot. Although malignant this is not deeply invasive so treatment can be successful. The other cancer affecting the nail bed is melanoma. If you have a sudden dark area appear under the nail without any injury please ask for a second opinion. A straight pigmented line, bleeding or a dark pigment that changes colour should not be ignored.


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