The second part of our chilblains double-header focused on these skin manifestations alongside the current global pandemic, specifically the chilblains (ie COVID toes), and what the changing and emerging evidence is telling us (currently). We were joined by Nadia Dembskey, who obtained her Bachelors and Masters degrees from the University of Johannesburg, sits on the Podiatry Association of South Africa National Executive Committee and has just submitted her PhD proposal to investigate this exact phenomena of ‘COVID toes’.
All the studies mentioned in this video on COVID Toes (and more) are linked in this thread on Podiatry Arena (and it continues to be updated):Chilblains and Covid-19 (Covid Toes)
In this episode we were joined by the Podiatrist, Joseph Frenkel. Joseph has 15 years clinical experience, a professional diploma in Dermatology and a Masters degree in Wound Healing & Tissue Repair. In this episode he was kind enough to walk us through everything we need to know about Chilblains, including the pathophysiology, the clinical manifestations, management and (as always) the importance of a history taking, with an emphasis on the key things which may raise the index of suspicion of the lesion in front of you being a Chilblain.
About Joseph Frenkel:
Joseph Frenkel is a podiatrist in Melbourne, Australia having completed both a Bachelor of Podiatry and a Master of Science with a specialty in Wound Healing and Tissue Repair. Joseph has also completed a Professional Diploma of General Dermatology. Joseph has over 15 years clinical experience in all areas of Podiatry and has worked extensively across private practices, aged care facilities and hospitals. His most recent role is Consultant Podiatrist at the Skin Health Institute where he works with a team of Dermatologists to manage complex nail problems. In addition to his clinical work, Joseph Frenklel holds academic positions at several Universities where he provides clinical supervision and part-time lecturing. He also has regular speaking engagements at seminars, workshops and conferences and mentors Podiatry graduates.
In this episode we talked with Annette Davis and discussed what the evidence tells us (and doesn’t tell us) about footwear and falls, explains the role of the Podiatrist in screening for falls risk and how to communicate effectively regarding this (making a reasonably solid case for all individuals of a certain age to be risk assessed regardless of why they are attending clinic to see you) and also the talks about the reasons that older individuals choose certain shoes and the challenges this can bring to the Podiatrist-patient interactions.
About Annette Davis:
Annette is Podiatrist in Melbourne, Australia and is currently serving as a Project Manager at the Department of Health and Human Services, Victoria. She is currently completely her PhD on footwear and falls at Monash University.
In this episode we welcomed Dr David Armstrong, DPM, PhD and we talked about how the worlds diabetic population is third only to China and India, and that during the length of this episode alone 198 amputations would have occured worldwide, and 565 people would have died from complications associated with Diabetes. We talk about what we as Podiatrists can try to do about this, how we communicate with and educate our patients, David’s approach to neuropathic assessment, and how Diabetic foot ulcers are not unlike training load injuries.
About David Armstrong:
David Armstrong DPM, PhD is Professor of Surgery at the University of Southern California. David holds a Masters of Science in Tissue Repair and Wound Healing from the University of Wales College of Medicine and a PhD from the University of Manchester College of Medicine, where he was appointed Visiting Professor of Medicine. He is founder and co-Director of the Southwestern Academic Limb Salvage Alliance (SALSA). Daivd has produced more than 500 peer-reviewed research papers in dozens of scholarly medical journals as well as over 80 book chapters. He is also co-Editor of the American Diabetes Association’s (ADA) Clinical Care of the Diabetic Foot, now in its third edition.
In this episode we squeeze some real vascular gems out of Martin and Peta, and talk about what a vascular assessment should look like, the importance of doppler use (and common mistakes made), we listen to some doppler waveforms live (and appreciate how relying on our ears alone may not be ideal), and identify the importance of good history taking and screening in individuals with known risk factors (particularly given that 50% of those with PAD are asymptomatic).
About Martin Fox:
Martin works in a CCG-commissioned, community-based NHS service in Manchester; providing early identification, diagnosis and best clinical management of people with suspected peripheral arterial disease (PAD). Previous clinical posts have included NHS podiatry, high-risk foot teams and a leprosy street clinic in Kolkata. He has also worked on a professional executive committee for his NHS Trust, regionally in podiatry clinical effectiveness groups, nationally for Foot in Diabetes UK, the NICE Guideline Development Group for PAD, the College of Podiatry and he contributes to the All Party Parliamentary Reports on PAD. He presents at conferences and has written journal articles on various aspects of high-risk foot care and lower limb vascular disease.
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