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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Dust Mites Under Skin And Wound On Toe

Aloha, Dr. Rynne. I have a question that will determine whether or not my life can be saved. I noticed a pencil-like black line on my big toe about 10 years ago and asked several local doctors what it was and they all kept telling me that it was a mole and/or fungus. I went to a Dermatologist, Dr. Howard (PA}, 3 weeks ago for an allergy that I developed just 10 months ago .. dust mites and a couple of other bugs that s imbedded under my skin, from head to toe. As my doctor was walking out of the examining room, he noticed the black spot on my big toenail, turned around and got on one knee to examine it carefully. He looked very concerned and had the specialist, Dr. Bessinger, with whom he shares the office with who is so busy, I could not get an appointment to see him, come into the examining room to confirm what he suspected. The black line had grown to be half of my toenail and a fraction of an inch on the skin just above the black mark under my big toenail. Dr. Bessinger did a biopsy immediately, removing my toenail, and asked me to return in 2 days, for the results from the Pathologist. Upon my return, both doctors came into the examining room to give me the bad news .. that I was diagnosed as having melanoma on my big toe. I was then referred to see a surgeon (skin cancer specialist/clinic) who said I need to have the top of my big toe, the size of a quarter, removed and explained what and why the surgery was necessary. I returned a couple of days later so Dr. Boyer could surgically removed a good amount of skin/flesh from the top of my big toe. He had the nurse remove the stitches that Dr. Bessinger had to do after removing my toenail and cauterize the open wound to stop the bleeding. I ve been doing the bandage change and application of a cocktail of anti-fungal and antibiotic ointments. The surgery was done on the 28th of August and my toe is discolored and swollen, tender to the touch. Please advise ..
Mon, 1 Jun 2020
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General Surgeon 's  Response
Hello,

As per my clinical experience, the discolored toe nail with pain and tenderness do indicate possible bacterial infection with gram positive bacteria as staph aureus or others most likely. The tissue is not showing up the healing status. My guidelines at present:
- Keep the area clean with antiseptic liquid or soap
- Sterile dressing with polymycin cream
- Get a culture swab report of the pus discharge done in microbiology laboratory
- Prescription of culture specific antibiotics for better infection resolution
- Supportive care with control of blood sugar
- Multi vitamins and minerals intake do support faster recovery
- Avoidance of smoking if involved
- Avoid tight shoes or walking barefoot

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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Suggest Treatment For Dust Mites Under Skin And Wound On Toe

Hello, As per my clinical experience, the discolored toe nail with pain and tenderness do indicate possible bacterial infection with gram positive bacteria as staph aureus or others most likely. The tissue is not showing up the healing status. My guidelines at present: - Keep the area clean with antiseptic liquid or soap - Sterile dressing with polymycin cream - Get a culture swab report of the pus discharge done in microbiology laboratory - Prescription of culture specific antibiotics for better infection resolution - Supportive care with control of blood sugar - Multi vitamins and minerals intake do support faster recovery - Avoidance of smoking if involved - Avoid tight shoes or walking barefoot Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon