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I like to treat keratomas and other punctate keratotic lesions with sublesional injections of 4% alcohol. I have been successfully using this technique for almost 30 years and I have written about it several times. Everyone has a treatment that they prefer, whether it is acid, cryotherapy, debride & pad, surgery, etc. and this is my preferred approach.
Dockery GL and Nilson RZ: Intralesional Injections. In, Dockery GL (ed.): Dermatology of the Lower Extremities, Clinics Pod. Med. Surg., W.B. Saunders Co., Philadelphia, Vol. 3, 3: July 1986, pp. 473-486.
Dockery GL: Evaluation and Treatment of Metatarsalgia and Keratotic Disorders. Ch. 12, In, Myerson MS (ed): Foot and Ankle Disorders, W. B. Saunders Co., Philadelphia, 1999, pp 359-377.
Dockery GL, Crawford ME: Evaluation and Management of Keratotic Disorders of the Foot. Atlas of Office Procedures. W. B. Saunders Co., Philadelphia, 3:1-21, 2000.
I usually reduce as deep as I can without anesthesia then have the patient apply 10% Formalin twice per day for two weeks. When they return I will remove the callous that has formed and frequently this simple technique will eradicate the poro.
When it does not, (or if I'm running on time) I anesthetize the area, curette and apply 88% phenol. This almost always works.
Steve
__________________
DrSArbes
Fellow American College of Foot & Ankle Surgeons
Board Certified Foot & Ankle Surgery, ABPS
Adjunct Professor OCPM
Green Bay, Wisconsin, USA
I like to treat keratomas and other punctate keratotic lesions with sublesional injections of 4% alcohol. I have been successfully using this technique for almost 30 years and I have written about it several times. Everyone has a treatment that they prefer, whether it is acid, cryotherapy, debride & pad, surgery, etc. and this is my preferred approach.
Dockery GL and Nilson RZ: Intralesional Injections. In, Dockery GL (ed.): Dermatology of the Lower Extremities, Clinics Pod. Med. Surg., W.B. Saunders Co., Philadelphia, Vol. 3, 3: July 1986, pp. 473-486.
Dockery GL: Evaluation and Treatment of Metatarsalgia and Keratotic Disorders. Ch. 12, In, Myerson MS (ed): Foot and Ankle Disorders, W. B. Saunders Co., Philadelphia, 1999, pp 359-377.
Dockery GL, Crawford ME: Evaluation and Management of Keratotic Disorders of the Foot. Atlas of Office Procedures. W. B. Saunders Co., Philadelphia, 3:1-21, 2000.
Dockery GL: Dilute Alcohol Injections for Nerve Conditions and Keratotic Lesions of the Foot. Podiatry Management. p.117-126, January 2004.
Hi Gary!
Great to see you posting on the Arena (Hope you remember me, we met at the FIP congress in Amsterdam last year). Please continue to do so, your expertise in cutaneous disorders would be most welcome here.
Many thanks for the refs. Just what I`ve been looking for
What is recommended as the best way to treat a Porokeratoma? It highly resembles a plantar wart but it is not.
Salicylic Acid pads? Cryotreatment? Surgery only? It is about 3-4 mm in diameter near the 5th metatarsal area?
Do they return like a plantar wart? If so what is the percentage of the time?
Thanks
Hi again Tim,
Would love to be able to offer advice on this case (with which you have frequently started threads on over the past year ). However, I would suggest that it would be courteous of you to answer the original questions;
Quote:
Originally Posted by Catfoot
timbogates, I have never heard of pyuvuric acid. Is it a proprietary substance not available in UK?
Catfoot
Quote:
Originally Posted by blinda
Hi timbogates,
Not entirely sure what you are asking ? Histology can determine whether there are viral particles present (wart), or not (callus), in the sample taken.
Why were x-rays taken?
Cheers,
Bel
Quote:
Originally Posted by Robertisaacs
Hey Timbo.
A keratosis tells us only that there is a growth of the skin. Could be callus, H durum, Hmille, V pedis, fiberous HD or "other". The best treatment will depend on which it is. 2-3rd suggests its not on the met head and if its a single lesion it raises questions about what it is.
We need more information to help you.
Quote:
Originally Posted by SarahR
Age? Abnormal Biomechanics, or structural deformity? Available ROMs etc? Gait findings? Type of pad will also depend on whether your goal is to improve function or simply provide palliative deflection.
Hey, life is too short to be skirting around. Let`s start again. Cards on the table, Tim. Are you a podiatry student or `is this your foot` as my honourable friend Mr Isaacs so eloquently pointed out?
Porokeratoma - Treatment
). However, I would suggest that it would be courteous of you to answer the original questions;
? Histology can determine whether there are viral particles present (wart), or not (callus), in the sample taken.
Linear Mode
