Brief Answer:
expert advise/investigations/management

Detailed Answer:
Hi Mr. XXXXXXX

Thanks for the query. I understand your concern.

Foot Infection is difficult to manage because of its weight bearing function/movements/chances of getting repeated injury & soiling.

Usually it starts with a trauma/abrasion/puncture wound, skin involvements like exaematus lesion, misfitting shoes. These get secondarily infected to form inflammation, ulcers, getting deep in the skin, soft tissue, may be sometimes up to the bones.

You seem to have an ulcerative circular lesion with scaling of skin on your foot.

Looking at it's chronic standing I would like you to exclude few conditions-
1 - Diabetes. In diabetes due to raised blood sugar, infections do not respond to routine treatment.
You should get your fasting & post meal blood & urine sugar tested & in case it is Raised- consult a Diabetologist for further investigations & specific treatment.

A controlled blood sugar along with proper management of infection will heal completely.

2. Peripheral vascular disease- This causes narrowing of peripheral blood vessels & condition needs to be excluded, as it causes chronic infections, more so in lower limb.

The diagnosis is made by USG-Doppler, angiography, computerised Tomography.

Please consult a surgeon for his expert advise For management of the wound as well as peripheral vascular disease.

3. Treatment of the infection- Infection can be bacterial/fungal.

A detailed CBC, Hb% & culture & sensitivity of the exudate from the infection site are usually done to define the exact causative organism & the sensitive antibiotic, medicine will be selected.

A proper dose schedule for a sufficiently long period is then decided.

Accompanying medicines like anti inflammatory drugs, vitamin B,C along with nutritive diet adds to healing process.

Local management of the infection ulcer with proper cleaning, removal of dead tissue & application of healing agent is to be followed regularly till complete healing. This should be done under expert surgeons care.

Wearing of proper shoes/socks to protect foot from further injury of new healing tissue should be followed after the treatment.

I hope I have answered your query to satisfy you. Any follow up query is welcome.

Thank you.

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