The patient states that he has gentle warts.
A transcription error found in a patient’s chart.
I’m so happy that the patient’s *genital* warts are being nice to him… all giving him backrubs after a hard day, baking pancakes on the weekends, never yelling when he forgets to wear a condom… :)
I was hoping I could send pictures with this question but I will post them on my page. A few years ago, I dislocated my big toe during rehearsals for a performance. I know it was dislocated because it was visibly deformed and I was able to put it back in place eventually. Also, I have continued increased mobility of the joint which causes problems every now and then.
Since then, I have had a callous build up on the second joint of my big toe (not at the head of the metatarsal-phalangeal joint). Just distal of of the MP joint. There is a rather hard lump that feels like it is below the skin. After a year of trimming it (the callous would grow over time to where it would be uncomfortable), I had my mother (a nurse) look at it. I know she isn't a doctor but her advice has always been a good starting point. She thought it was a corn. I have been treating it for the last week with medicated (salicylic acid) corn pads and the results can be seen in the photos on my page. The hard spot under the joint is still there and still feels like it is underneath the skin in the tendon. I haven't had health insurance in nearly six years and if I can fix it with over the counter remedies, I choose those. Any theories on what it could be? It remains tender and is starting to affect my walking patterns.
And this update a few days later:
I have updated the photos of my toe. While the callous has gotten smaller, the underlying lump is still there. I think, eventually, I will have to have whatever it is excised. According to the packaging for the medicated corn pads, I have reached the end of the treatment period.
And here are all the yummy toe pictures from ChallengeScience’s Tumblr.
Well, a corn is a possibility, for sure, or even a coincidental plantar wart. But, I wonder if perhaps, during the dislocation, a piece of bone got avulsed (chipped off the edge) and has been floating in the space between the joint and the skin, gradually working it’s way up to the surface and causing a callus?
That’s my best guess. If you decide to spend the money on seeing a doctor, I’d go straight to a podiatrist in your case. Good luck! And thanks for the pics.
***Pending Cranquis-Mails: 39***
Hey Dr. Cranquis,
After spending the better part of my evening reading through roughly 40 pages of your old posts/answers, I felt as though I absolutely had to post something to make my presence on this magical blog visible. In all seriousness though, this 16 year old who is actually quite interested in the medical field, does have two (somewhat) legitimate questions.
1.) There's been a small bump on the side of my left thumb for the past couple months, and it took me a good amount of time to realize that it was a wart. And being a strange person, as soon as I self diagnosed myself with the help of Dr. Google, I went ballistic. I had to get rid of it.
My family isn't in the best financial situation, despite that my mother spends most of her time working (thanks father!), and although I am on Medicaid, I don't want to abuse it for a single wart on my thumb. It isn't really visible, but I know it's there, and it drives. Me. Nuts.
So, to (finally) cut to the chase, I got a pair of sanitized toenail clippers, and ripped out the skin with the wart, the skin within a radius of 3 millimeters to the wart, and quite deeply at that. It bled a lot, so I held my thumb under a sink as I snipped away. It hurt quite a bit (but I am quite intolerant of pain, so there's also that), and I did wipe alcohol all over it finished bleeding, but it wasn't even worth it. I'm not sure what I was expecting from this, but it grew back, and being complete fool, I repeated the process about 3 times. Last night, I cut a fifth of my thumb off, causing a huge bloody mess all over my sink.
Are there any home remedies for this? Is what I'm doing helping at all (I do cut out all the little black dots, and then some)? Should I go to the doctor about this, since it's to the point where I am self mutilating myself? I would really like to avoid that, if possible, but your opinion would override any irrational logic I could pull out from my butt to keep me from telling my mother, and going to get this checked out.
2.) Being Korean, born from two parents roughly 5'1" or so, I never thought I'd grow up very tall, but I'm 4.9". And I've been 4'9" for over 2 and 1/2 years. I'm fit, I don't drink caffeine aside from the occasional tea, and I exercise regularly.
My mother insisted (and still does to this day) that I stuff myself with food to the point of bursting, in hopes of growing taller, because that is clearly how people grow tall. Well, contrary to my mother's advice, my diet is on the slightly less than normal side. It's not uncommon for me to skip meals a few meals a week, but I don't do it for any other reason aside from my lack of hunger. I've never really slept a healthy amount of time, either (roughly 4~6 hours every night since I was about 12), and I've heard that also affects growth hormones?
Can these factors really stunt my growth? Is there really nothing I can do to magically stop whatever is stunting my growth, or make myself magically grow taller? This is kind of a silly question, and I can probably guess your reply, but I just had to ask. Because, quite frankly, being 4'9" for the rest of my life would suck.
Thanks, Dr. Cranquis.
I apologize for the excessively long post. I tend to add a lot of details. I hope this post doesn't give you a migraine.
Greetings! So I have a “magical blog” eh? And you’ve surfed all 40+ pages of the archives?! I’m ridiculously flattered. :)
Now, to reply to your 2 questions:
1) STOP MUTILATING YOUR POOR FINGER! :( Your theory is sound — after all, a wart (if that’s what it really is) is created by a virus which protects itself by growing all those layers of thick keratinous material. So removing the “warty” skin to expose the deeper tissue where the virus hides is definitely part of treating the problem. But if you do it yourself, with “sanitized toenail clippers” (what does that mean? You dipped ‘em in rubbing alcohol, you held them over a lit match, you boiled them in water? Still probably not sterilized enough to prevent infection!), repeatedly, to the point of causing bleeding, then you are putting yourself at great risk of bacterial infection. If you hadn’t messed with it yet, I’d recommend trying an over-the-counter product, such as Compound W, or even trying duct-tape occlusion therapy (which is possibly scientifically-supported, depending on which journals you read)
- wrapping the affected wart area in duct tape for 48-72 hours
- removing the duct tape, then soaking the area in hot water with epsom salt or white vinegar to soften the skin
- scraping the thickened warty layers with an emory board
- then re-wrapping with duct tape, and repeating process for up to 12 weeks. (In general, warts are very tenacious, so expect these types of treatments to take a long time).
HOWEVER, at this point, I think it’s time to use (not abuse) your Medicaid insurance and see a doctor about it, for definitive diagnosis and treatment options. Hopefully it’s not infected, and hopefully it’s not anything more serious than just a wart.
2) You’re not the first Asian person to write to me about their “vertically-challenged” status. Yes, your suboptimal sleep and nutrition patterns may contribute a little bit towards your overall height — but as I’ve said before, your height is primarily caused by your genetic heritage, and the main thing you can do about your height (or lack of it) is: learn to live with it. You’ve been at the same height for 2.5 years, so chances are that you’re not going to have any more growth spurts, no matter how much food you cram in. :S
Hope that helps you decide how to proceed with your 2 concerns. Good luck!
How would you treat a wart approximately 3 mm in diameter that is located near the base of the nail?
Hmm… well, Toadally Tubular, I don’t treat a lot of warts myself in my Urgent Care, since wart treatment is not really an “urgent” issue, but from what I know about how other doctors treat warts, your options can include:
- doing nothing and waiting for it to go away on it’s own — which doesn’t always work, can take a long time (years), and may not be a good option if the wart is getting infected or bleeding a lot or growing rapidly.
- putting duct-tape on it — I’m not kidding! The research on this is ALL OVER THE PLACE, but some studies seem to show that “occlusive therapy” (i.e. putting duct tape on the wart for up to 12 weeks) may help break down the warty “armor” that you see on the skin, and help expose the wart virus that lives deeper underneath. Hey, it can’t hurt!
- over-the-counter wart therapies, such as Compound W — which also take a while (months!) to work, and can be painful.
- cryotherapy — basically, using an extremely cold liquid (liquid nitrogen, etc) to freeze the wart, which makes the top layers of wart tissue die and fall off. This usually requires a few repeated treatments, and it can hurt for a couple days, but it can clear things up a bit faster.
- injecting it with fungus — again, I’m not kidding! I don’t know much about this, but I’ve had a couple patients tell me that their dermatologist did this to treat warts that had failed other therapies, and it worked for them.
So, there’s some ideas. If the wart is painful, bleeding, draining pus, rapidly enlarging, or appears to be growing under the fingernail itself, see a doctor about it, but don’t go to the ER/Urgent Care (unless you think it might be infected or you can’t stop the bleeding) — they’ll just tell you to see a primary care doc or a dermatologist. Good luck!