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#16904 - 12/31/06 07:20 PM 18 month old palmar plantar woes
Evan's Mommy Offline
Member

Registered: 08/11/05
Posts: 165
Loc: Portland, ME 04106
Hi all experienced EHKers-

Our little guy, Evan, is doing mostly well. He's officially walking which has resulted in many facial bumps and bruises (which is always so much fun in the grocery store - "Oh my what happened?"). His little feet are a disaster. Thick on the bottom, lots of thick skin bands on his toes and other dead skin coming off of the top of his feet. Plus, lots of blisters, which seem to be more abundant on his left foot. We know he's developed a few vlisters when he fusses with every step.
Evan is in the tub daily with a mild bleach solution. We only remove skin that is already coming off. We were using aquaphor on his feet but have switched to lotion which seems to have helped the new thin skin because it is less fragile.
Any advice or input would be welcome. Thanks so much and Happy New Year!

Sincerely,
Kimberly

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#16905 - 01/01/07 02:27 AM Re: 18 month old palmar plantar woes
Hearsay Offline


Member

Registered: 01/16/04
Posts: 1449
Loc: Richmond, VA, USA
Talk to Kacy about the banding. She's probably the best source on here.

As for the thick heels, file those puppies down. The thicker they get, the more they crack and hurt, and the more bacteria you grow.

1. Soften: Apply aquaphor to the bottoms at night, put on socks, then footed jammies. Socks on the hands, if she'll tolerate it. Bathe first thing in the morning. Soak as long as possible. Add a thick layer of cream ( Cetaphil is our first choice). Add a second layer about 20 minutes later. Have her wear socks and shoes all the time. If she has slippers, make sure they have a hard sole, like moccassins or boat shoes.

2. Soften more: As the day progresses, even with all of the above, the feet will dry out. You can wrap her feet in plastic cooking wrap for a few hours and it will trap moisture inside. Don't leave it on for more than 6-8 hours because it will start to grow mold, especially in shoes, but this is a good trick if you don't have time for a bath in the morning but you need her to walk (like when she starts preschool, for example.)

3. Humidity: Buy a humidifier for whatever rooms she spends the most time in. Keep it at 50%.

4. file: get the 100 grit heavy duty files from your local beauty supply place. File in the same direction as the cracks, so on the sides, you go left to right and on the heel, go front to back. Push directly on the crack so it is in the center of the file. If a crack catches and edge, it will tear and hurt. Expect lots of tears during the process, as it can be painful, but 18mo kids just don't like to be held down. You'll know the difference. Generally hard pressure and slow filing hurts less than light pressure or fast filing. Pressing lightly seems like it would hurt less, but pushing down often shuts off the surface level pain receptors. Moving fast means you get done sooner, but you can easily catch an edge and tear attached skin off. It is less painful if you file dry but softened skin - after a night with Aquaphor or after a few hours of wearing plastic.

5. file more: When she's older, like around age 4, you can very carefully use a hand sander like a Dremel on the thickest areas. It works best right after a shower or first thing in the morning after a night coated in Aquaphor. Any younger than 3 1/2 and all the thing will do is terrify her. It is fast, efficient, messy, loud, and creates a lot of heat. If the child is wiggling around, it is dangerous. I do it to Nathan now. I touch just the thickest spots, then release, over and over until it softens. If it starts to look even slightly pink, you are too close to live skin or it is starting to get a rug-burn-like burn. Either way, that's your cue to move on.

------------------
Reticular Ichthyosiform Erythroderma
_________________________
Jennifer
Ichthyosis-en-Confetti Type 2
Husband, Nathan - 10, Elliot - 7, Oliver - 4, all affected.
I also have an unaffected daughter, age 8.


email: jennifer at confettiskin dot com
facebook - find me on "ichthyosis mommy spot" or "friends of ichthyosis"

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#16906 - 01/02/07 08:21 PM Re: 18 month old palmar plantar woes
Evan's Mommy Offline
Member

Registered: 08/11/05
Posts: 165
Loc: Portland, ME 04106
Thanks so much for the thorough response.
Kimberly

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#16907 - 01/03/07 05:33 AM Re: 18 month old palmar plantar woes
pauline5 Offline
Member

Registered: 01/06/02
Posts: 913
Loc: Melbourne, Australia
Hi Kimberley, I just love that name, it was the name of our 16 year old girl (pussycat) who died 2 years ago...

I know how frustrating it must be trying to keep Evan's feet blister free, and feeling better in general...

I have EHK also...thick soles too...have you ever tried to soak his feet in some salt water...I have baths in it and find that if the feet are soaking for about 1 hour...the salt really seems to eat its way through the outer layers of the callous, and it literally just scrapes away so easily...

just putting his little feet in a bucket would be better at his age...i know it is hard for little ones to keep still long enough, at least you can encourage him to play while sitting there...

when I was about 4 years old, district nurses used to come 3 days per week and use a scalpel on my feet...surgical scalpel that is...of course this is quite dangerous when little feet are jiggling, and one is probably screaming in protest...but honestly, if your son can learn to tolerate it in older years, the scalpel gets it off much quicker, and with much less noise than an electric sander...as i imagine this would frighten the living daylights out of him...

When they finished scalpeling them down, (of course i always had to leave a substantial amount on there for padding and walking comfort...) They would sand them down smooth with ordinary sandpaper, but it had to be quite course, almost to the point of seeing the shavings of glass within it...

Boy I loooooved that part immensely, my eyes would cross in sheer bliss...So for the pain and protest of the scalpeling part, i was looking forward to the sandpapering...it was like getting one's back scratched...yummmo [img]http://www.ichthyosis.com/ubb/smile.gif[/img]

Listen, actually the scalpel doesn't hurt ... i think as children we make it more likely to hurt because we are not keeping still for it...I usually preferred to do it myself by about aged 8, because then i can feel when i am getting too low...the worst parts which made me nervous with the nurses doing it, was on the toes...a very delicate operation indeed [img]http://www.ichthyosis.com/ubb/smile.gif[/img]

I now go to a podiatrist and she spends 1 hour on each foot, and goes through about 7 blades...

Some people prefer to pare the feet down while they are hard, and others prefer them to be soaked first...it is an individuial thing...but i think for us it is less sensitive if they are softened first...

and Jennifer is right about what direction you put sandpaper on, or cutting for that matter...

always cut toward the thick stuff that is lifting around the foot, and cracks also...otherwise it really starts ripping up the skin that is firmly planted down on the foot...

I personally find, even now, the most senstive area apart from the toes, is the heal, for some reason, it must have more sensory receptors...so on a young child, avoid a scalpel in that area until they are old enough, to handle it...Just pare it down with dremel or sandpaper...

I also find that if I/podatrist cut too much away from the outer sides of the feet, it really thins it out to the point of making it blister...

How is your son's balance going? I suspect his left foot is blistering more because he is maybe putting more force/weight on that side...

Congrats on the walking ... how old is he?

Regards Pauline

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#16908 - 01/03/07 05:42 AM Re: 18 month old palmar plantar woes
pauline5 Offline
Member

Registered: 01/06/02
Posts: 913
Loc: Melbourne, Australia
Quote:
Originally posted by pauline5:
Hi Kimberley, I just love that name, it was the name of our 16 year old girl (pussycat) who died 2 years ago...

I know how frustrating it must be trying to keep Evan's feet blister free, and feeling better in general...

I have EHK also...thick soles too...have you ever tried to soak his feet in some salt water...I have baths in it and find that if the feet are soaking for about 1 hour...the salt really seems to eat its way through the outer layers of the callous, and it literally just scrapes away so easily...

just putting his little feet in a bucket would be better at his age...i know it is hard for little ones to keep still long enough, at least you can encourage him to play while sitting there...

when I was about 4 years old, district nurses used to come 3 days per week and use a scalpel on my feet...surgical scalpel that is...of course this is quite dangerous when little feet are jiggling, and one is probably screaming in protest...but honestly, if your son can learn to tolerate it in older years, the scalpel gets it off much quicker, and with much less noise than an electric sander...as i imagine this would frighten the living daylights out of him...

When they finished scalpeling them down, (of course i always had to leave a substantial amount on there for padding and walking comfort...) They would sand them down smooth with ordinary sandpaper, but it had to be quite course, almost to the point of seeing the shavings of glass within it...

Boy I loooooved that part immensely, my eyes would cross in sheer bliss...So for the pain and protest of the scalpeling part, i was looking forward to the sandpapering...it was like getting one's back scratched...yummmo [img]http://www.ichthyosis.com/ubb/smile.gif[/img]

Listen, actually the scalpel doesn't hurt ... i think as children we make it more likely to hurt because we are not keeping still for it...I usually preferred to do it myself by about aged 8, because then i can feel when i am getting too low...the worst parts which made me nervous with the nurses doing it, was on the toes...a very delicate operation indeed [img]http://www.ichthyosis.com/ubb/smile.gif[/img]

I now go to a podiatrist and she spends 1 hour on each foot, and goes through about 7 blades...

Some people prefer to pare the feet down while they are hard, and others prefer them to be soaked first...it is an individuial thing...but i think for us it is less sensitive if they are softened first...

and Jennifer is right about what direction you put sandpaper on, or cutting for that matter...

always cut toward the thick stuff that is lifting around the foot, and cracks also...otherwise it really starts ripping up the skin that is firmly planted down on the foot...

I personally find, even now, the most senstive area apart from the toes, is the heal, for some reason, it must have more sensory receptors...so on a young child, avoid a scalpel in that area until they are old enough, to handle it...Just pare it down with dremel or sandpaper...

I also find that if I/podatrist cut too much away from the outer sides of the feet, it really thins it out to the point of making it blister...

How is your son's balance going? I suspect his left foot is blistering more because he is maybe putting more force/weight on that side...

Congrats on the walking ... how old is he?

Regards Pauline


p.s. actually I agree with Jennifer, maybe filing/scalpeling is better done dry, as the outer layer is rock hard, and once you reach the underneath it is quite soft, so it helps you to gauge how close you are getting down...another way of knowing you are getting to low, is the skin will turn a yellow colour when it is close to the living skin...

I hope i didn't suff up the direction i mean to cut from...I meant start cutting a fair way away from the lifted area, and scrape towards it, from the centre out (out being where open skin is)

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#16909 - 01/03/07 05:44 AM Re: 18 month old palmar plantar woes
pauline5 Offline
Member

Registered: 01/06/02
Posts: 913
Loc: Melbourne, Australia
Quote:
Originally posted by pauline5:
Hi Kimberley, I just love that name, it was the name of our 16 year old girl (pussycat) who died 2 years ago...

I know how frustrating it must be trying to keep Evan's feet blister free, and feeling better in general...

I have EHK also...thick soles too...have you ever tried to soak his feet in some salt water...I have baths in it and find that if the feet are soaking for about 1 hour...the salt really seems to eat its way through the outer layers of the callous, and it literally just scrapes away so easily...

just putting his little feet in a bucket would be better at his age...i know it is hard for little ones to keep still long enough, at least you can encourage him to play while sitting there...

when I was about 4 years old, district nurses used to come 3 days per week and use a scalpel on my feet...surgical scalpel that is...of course this is quite dangerous when little feet are jiggling, and one is probably screaming in protest...but honestly, if your son can learn to tolerate it in older years, the scalpel gets it off much quicker, and with much less noise than an electric sander...as i imagine this would frighten the living daylights out of him...

When they finished scalpeling them down, (of course i always had to leave a substantial amount on there for padding and walking comfort...) They would sand them down smooth with ordinary sandpaper, but it had to be quite course, almost to the point of seeing the shavings of glass within it...

Boy I loooooved that part immensely, my eyes would cross in sheer bliss...So for the pain and protest of the scalpeling part, i was looking forward to the sandpapering...it was like getting one's back scratched...yummmo [img]http://www.ichthyosis.com/ubb/smile.gif[/img]

Listen, actually the scalpel doesn't hurt ... i think as children we make it more likely to hurt because we are not keeping still for it...I usually preferred to do it myself by about aged 8, because then i can feel when i am getting too low...the worst parts which made me nervous with the nurses doing it, was on the toes...a very delicate operation indeed [img]http://www.ichthyosis.com/ubb/smile.gif[/img]

I now go to a podiatrist and she spends 1 hour on each foot, and goes through about 7 blades...

Some people prefer to pare the feet down while they are hard, and others prefer them to be soaked first...it is an individuial thing...but i think for us it is less sensitive if they are softened first...

and Jennifer is right about what direction you put sandpaper on, or cutting for that matter...

always cut toward the thick stuff that is lifting around the foot, and cracks also...otherwise it really starts ripping up the skin that is firmly planted down on the foot...

I personally find, even now, the most senstive area apart from the toes, is the heal, for some reason, it must have more sensory receptors...so on a young child, avoid a scalpel in that area until they are old enough, to handle it...Just pare it down with dremel or sandpaper...

I also find that if I/podatrist cut too much away from the outer sides of the feet, it really thins it out to the point of making it blister...

How is your son's balance going? I suspect his left foot is blistering more because he is maybe putting more force/weight on that side...

Congrats on the walking ... how old is he?

Regards Pauline


p.s. actually I agree with Jennifer, maybe filing/scalpeling is better done dry, as the outer layer is rock hard, and once you reach the underneath it is quite soft, so it helps you to gauge how close you are getting down...another way of knowing you are getting to low, is the skin will turn a yellow colour when it is close to the living skin...

I hope i didn't suff up the direction i mean to cut from...I meant start cutting a fair way away from the lifted area, and scrape towards it, from the centre out (out being where open skin is)

another clarifying matter: when the feet are soaked, you can get away with just scraping actions with scalpel, but when they are rock hard, you actually have to cut away...and watch it fling off in all directions, that can be fun, watch out for your eyes too... [img]http://www.ichthyosis.com/ubb/smile.gif[/img]
The podiatrist told me last time, that she was still finding skin in her office 7 days after i visited... hehehe, I roared laughing...

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#16910 - 01/03/07 07:21 AM Re: 18 month old palmar plantar woes
pauline5 Offline
Member

Registered: 01/06/02
Posts: 913
Loc: Melbourne, Australia
p.s. actually I agree with Jennifer, maybe filing/scalpeling is better done dry, as the outer layer is rock hard, and once you reach the underneath it is quite soft, so it helps you to gauge how close you are getting down...another way of knowing you are getting to low, is the skin will turn a yellow colour when it is close to the living skin...

I hope i didn't suff up the direction i mean to cut from...I meant start cutting a fair way away from the lifted area, and scrape towards it, from the centre out (out being where open skin is)

another clarifying matter: when the feet are soaked, you can get away with just scraping actions with scalpel, but when they are rock hard, you actually have to cut away...and watch it fling off in all directions, that can be fun, watch out for your eyes too... [img]http://www.ichthyosis.com/ubb/smile.gif[/img]
The podiatrist told me last time, that she was still finding skin in her office 7 days after i visited... hehehe, I roared laughing...[/B][/QUOTE]

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#16911 - 01/04/07 04:20 AM Re: 18 month old palmar plantar woes
Hearsay Offline


Member

Registered: 01/16/04
Posts: 1449
Loc: Richmond, VA, USA
Pauline, that's a good point about the scalpel.

When we were first married, my husband used a pocket knife to hack off big chunks of callous. I was getting acrylic nails at the time, which is how I came across the Dremel idea. He has completely switched over to that now, as you have a lot more control and get fewer chunky edges with the sander.

A lady friend of my MIl's comes over and does hair and massage and whatnot. She's a manicurist or something. She had a neat little tool that looked a lot like a bottle opener with a razorblade in the middle. That did about an equally good job as the Dremel, but it took her almost an hour to do his feet when the Dremel is a 10 minute project.

No matter what you do, it makes a huge mess. We actually put the sander in the shower and line the bottom with towels. That way, once done, we can fold the towels and put them straight in the washer and run/clean the shower to get the particles off the walls.

For our type, the salt water baths don't seem to be any improvement over regular water. Your mileage may vary, as we have a pretty obscure variety.

Jennifer

------------------
Reticular Ichthyosiform Erythroderma with white spots.
Husband, Nathan - 4, Elliot - 1, all affected.
_________________________
Jennifer
Ichthyosis-en-Confetti Type 2
Husband, Nathan - 10, Elliot - 7, Oliver - 4, all affected.
I also have an unaffected daughter, age 8.


email: jennifer at confettiskin dot com
facebook - find me on "ichthyosis mommy spot" or "friends of ichthyosis"

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#16912 - 01/04/07 12:49 PM Re: 18 month old palmar plantar woes
pauline5 Offline
Member

Registered: 01/06/02
Posts: 913
Loc: Melbourne, Australia
Hi jennifer, i had a little giggle about the walls...i can just see it...

yes the scalpel does leave jaggered edges on soles, but that is the very reason why we always used sandpaper afterards, to smooth it all out...

that is amazing about how fast the Dremel works... How thick are the soles? I would love to see some photos some time, there are not many of us with palmoplanter, and it would fascinate me to see someone else's feet...

of course, that is if you or your husband doesn't mind...

How is his type of EHK different to mine...?

Pauline
P.S. what on earth did i do wrong with mu extra post yesterday, boy, what a mess...

[This message has been edited by pauline5 (edited January 04, 2007).]

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#16913 - 01/04/07 05:34 PM Re: 18 month old palmar plantar woes
Hearsay Offline


Member

Registered: 01/16/04
Posts: 1449
Loc: Richmond, VA, USA
I have pictures on my home computer. Remind me and I'll put them up next week when I get back from holiday travel. All I have online right now are infant pictures of my boys, and the skin isn't very built up on them when the pictures were taken.

Nathan's hand at 10mo:
[img]http://i5.photobucket.com/albums/y170/12hearsay12/DSCN0664.jpg[/img]

Brian's elbow with the white spots and elbow buildup:
[img]http://i5.photobucket.com/albums/y170/12hearsay12/DSCN2397.jpg[/img]

Elliot foot at 1 month:
[img]http://i5.photobucket.com/albums/y170/12hearsay12/DSCN4015.jpg[/img]

Elliot hand, 1 month:
[img]http://i5.photobucket.com/albums/y170/12hearsay12/DSCN4014.jpg[/img]

------------------
Reticular Ichthyosiform Erythroderma with white spots.
Husband, Nathan - 4, Elliot - 1, all affected.
_________________________
Jennifer
Ichthyosis-en-Confetti Type 2
Husband, Nathan - 10, Elliot - 7, Oliver - 4, all affected.
I also have an unaffected daughter, age 8.


email: jennifer at confettiskin dot com
facebook - find me on "ichthyosis mommy spot" or "friends of ichthyosis"

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