Case study By Steven Goldstein, DPM; Basem Halaka, DPM; David Vance, DPM; Jason Weslosky, DPM History of Present Illness The patient is a 62 year old male with a 2 year history of thickened, elongated, and yellow discolored nails of the hallux bilateral. The nails appear dystrophic with evidence of subungual debris. The patient does not recall any significant trauma to the nails but does admit to uncomfortable rubbing of the bilateral hallux nails in his shoes. The patient does not have any other contributing medical history. Click on image to enlarge Differential Diagnosis Diagnostic [...]


What podiatrists need to know about dermatopathologists


Q&A with two Bako Diagnostics dermatopathologists: Kim Whisenant, M.D., and Carolina Montes, M.D. on partnering with podiatrists Q. What is the importance of podiatrists being familiar with pathology, specifically dermatopathology? A. Dr. Montes: The skin is the largest organ of the body, and many medical specialties, including podiatry, come in contact with disorders of the skin. Lesions that appear on the skin, including the foot, can also be a manifestation of internal systemic disease. Consequently, it’s important for clinicians to be familiar with both inflammatory and neoplastic processes of [...]

What podiatrists need to know about dermatopathologists2021-03-09T14:30:28-05:00

Overview: Green Nail Syndrome


Green nail syndrome (GNS) is the most common bacterial infection of the nail unit. Green nail syndrome (GNS) is the most common bacterial infection of the nail unit. Both the upper and lower extremities may be affected in GNS, but is uncommonly reported as a primary cause of onychodystrophy. The causative organism, Pseudomonas aeruginosa, is a gramnegative bacteria which is ubiquitous in nature favoring warm and moist environments with reservoirs in soil, water, plants and animals. Infection of the nail results in chloronychia as a direct result of the production of pyoverdin and pyocyanin by P. aeruginosa. BakoDx DNA [...]

Overview: Green Nail Syndrome2021-02-17T17:27:31-05:00

Web Space Dermatophytosis


By Adi Pajazetovic, DPM, Kalani Parker, DPM Tinea pedis resistant to treatment may require systemic antifungals History A 67-year-old male with no known significant past medical history presented to clinic with an itchy dermatitis like lesion within his left fourth web space. Lesion has been present for an undefined length of time. Physical Examination Patient presented with an eczematous/tinea like lesion within the left fourth web space along with maceration to the area. Diagnostic Testing A shave biopsy was performed and a submission of a skin fragment measuring 0.3 x 0.3 x 0.1 cm was received [...]

Web Space Dermatophytosis2021-03-03T18:39:32-05:00

Molluscum Contagiosum


By Courtney McClurkin, DPM; Andrew Olson, DPM Molluscum contagiosum can be confused with a variety of different skin pathologies History A 25 year old male with no known significant past medical history presents with a pigmented lesion to plantar aspect of his left foot present for an undetermined period of time. Physical Examination A raised red and black 3mm lesion is seen on the plantar aspect of left foot. Diagnostic Testing A 2mm punch biopsy was performed with clinical concern to rule out melanoma. Histological Findings Typical histological features of molluscum contagiosum were identified including [...]

Molluscum Contagiosum2023-01-26T12:15:58-05:00

Erythema Elevatum Diutinum


By Desiree Dalcherone, DPM; Laura Fernandez, DPM; Pooja Srivastava, DPM Lesions are usually asymptomatic, but some cases might present with itching and pain History Patient is a 29 year old male with past medical history of Crohn’s disease, presenting with a one year history of progressively worsening, painful nodules to his bilateral legs and feet. A punch biopsy of skin was taken from the nodule present to the patient's plantar-medial left hallux. Physical Examination Multiple nodules were present on bilateral legs and feet. Click on image to enlarge Click on image to enlarge [...]

Erythema Elevatum Diutinum2021-03-03T20:07:55-05:00



By Morgan Baxter, DPM, Aron Block, DPM, Lillian Youhkana, DPM Blastomycosis is a type of fungal infection that can be acquired from inhaling fungal spores History A 53 year old healthy male presents to clinic with concerns of a rash involving raised bumps for about a month. He thought it was a cluster of warts, but has not had any relief with over the counter topical medications. He does mention that about a month ago, he was raking leaves barefoot. The bumps are not painful but have started to leak and have not gone away. He resides in [...]


DNA-based Onychomycosis Detection Correlates Better to Histopathology than does Fungal Culture


CLINICAL STUDY DNA-based detection for onychomycosis correlates better to histopathology than does fungal culture BakoDx PCR Testing

DNA-based Onychomycosis Detection Correlates Better to Histopathology than does Fungal Culture2021-04-21T09:32:50-04:00

Biopsy Planning and Post-Biopsy Tissue Handling : A Synopsis


Introduction As a general rule, the podiatic profession is notorious for its underutilization of cutaneous and soft tissue biopsy techniques. In some instances, such under-use may be attributed to trepidation stemming from a lack of familiarity with the biopsy techniques themselves; however, I believe this is not the preeminent cause. In my experience, the most common reason that many podiatric clinicians don’t use biopsy techniques to their fullest is a degree of insecurity regarding when to use witch biopsy and what to do with them once the biopsy has been performed. In most offices, the support staff is ill prepared [...]

Biopsy Planning and Post-Biopsy Tissue Handling : A Synopsis2017-11-24T19:22:22-05:00

Cutaneous Biopsy Techniques in the Management of Chronic Wounds


Many clinicians rely exclusively on clinical acumen when determining how to manage chronic wounds. Though an ulcer’s clinical features may be fairly indicative of its etiology, in some instances, such is not the case. Even among the most characteristic‐appearing ulcerations, masqueraders do exist. Ruling out the possibility of an unsuspected neoplastic or inflammatory condition could be necessary for the successful management of chronic wounds. In this context, cutaneous biopsy techniques may be invaluable; however, their utility does not necessarily end here. There are three common clinical settings in which a biopsy may be used in the management of a chronic wound. [...]

Cutaneous Biopsy Techniques in the Management of Chronic Wounds2017-11-24T19:32:38-05:00
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