Question
Hi Dr. Katz:
I am a 43 year old with Type 1 diabetes, diagnosed at 28. At my request, my diabetes specialist referred me to a podiatrist for general diabetic foot care. This was not a
diabetic foot doctor. He is a podiatrist who has in a clinic once a week in the hospital where my diabetes specialist practices.
When I saw the podiatrist he noted a small wart on the bottom of my foot, near the crease where the big toe is joined to the foot. I told him that I had this
treated previously by a dermatologist but that it hadn't gone away.
The podiatrist proceeded to apply something to the wart. He then covered it with a piece of tape. He told me a blister would develop and then go away and I may experience 'some' pain. I was to see him again almost a month later.
Within hours of this 'treatment' my foot became extremely painful in that area and I could barely walk on it. I kept off it for the remainder of the day. The next day I was quite ill. I thought maybe I had the flu - I had chills and
sweats and felt 'out of it'. My foot was very painful but I was distracted by the flu like symptoms. That evening I couldn't even stand the weight of a sheet on my foot.
The next day, noting my foot was swollen and red with extreme pain, I went to the emergency room at the hospital.
By this time there was a red line going from my foot, partway up my shin. My foot was obviously infected (the cause of feeling ill the previous day) and once
admitted, they discovered there was a big abscess. When the emerg. room Dr. drained the abscess it left a large hole in my foot. As a result, I was on an IV with antibiotics, in addition to oral antibiotics, for two weeks. I was on crutches and was told I could not work for two weeks. I was very worried as I am aware of the
problems diabetics face with infections and was actually afraid I might lose my foot and/or leg. Fortunately, with daily wound care it healed quite nicely but I now have numbness in my big toe and the two beside it.
I discovered that the podiatrist put a chemical agent called Cantherone (aka Cantharadin)on my foot.  All my research shows that this should not be used on diabetics.
Do you feel his treatment was appropriate for a diabetic? Is it an accepted practise to use such things on a diabetic even though the makers warn not to?
Also, I am assuming I now have nerve damage although I am told this could go away? (it has been approx. 4 months). Lastly, what would have caused the nerve damage - the infection or the abcess?

Thank you in advance for any information you can provide.  

Answer
Hi Giselle,

I'm sorry you had complications.  Cantharone is used for warts and works well.  On the bottle it warns a consumer not to use on diabetics.  A podiatrist or other physician certainly can use the chemical if deemed medically necessary.  It sounds like you had a complication and these things happen as a result of some medical treatments.

I personally cannot judge your dr with respect to appropriate treatment however, problems can occur with any treatment and drs cannot be blamed for all problems that occur.

If I were you, I would be happy that you healed well following the problem and hope that the nerve problem resolves.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

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