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Psoriasis of the Foot

This week was my week to see cases of psoriasis. Psoriasis is an autoimmune disorder that is manifested by the rapid turn over of skin cells resulting in disruption of normal skin production. There are 5 different classifications of psoriasis based on their appearance. The two most common that we see in foot care are plaque and pustular psoriasis.

When and why do you cancel surgery?

I'm on call this week for our hospital's Critical Limb Care program. First thing Monday morning I had a call from a cardiologist who wanted to know whether to proceed or cancel an angioplasty (PCA). The case was an ablation of the right atrium. The problem was that the patient presented with a mid shin wound that had been present for 3 weeks. The question at hand was whether the wound was infected and would contaminate the procedure. "What should I do? Cancel the case?"

Does methotrexate influence wound healing?

Methotrexate is an antimetabolite that works by inhibiting dihydrofolic reductase. This enzyme is important in the production of DNA. Methotrexate targets rapidly growing cells such as inflammatory cells in rheumatoid arthritis or psoriasis. Methotrexate was originally used as a cancer drug for malignancies including acute lymphoblastic leukemia and lymphomas.