Immersion foot syndromes

Immersion foot
Trench foot as seen on an unidentified soldier during World War I
Classification and external resources
ICD-10	T69.0
ICD-9-CM	991.4
DiseasesDB	31219
Patient UK	Immersion foot syndromes

Immersion foot syndromes include trench foot, tropical immersion foot, and warm water immersion foot.^[1]^:26-7

Causes

Trench foot

Main article: Trench foot

Trench foot is a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions. The use of the word trench in the name of this condition is a reference to trench warfare, mainly associated with World War I. Affected feet may become numb, affected by erythrosis (turning red) or cyanosis (turning blue) as a result of poor vascular supply, and feet may begin to have a decaying odour due to the possibility of the early stages of necrosis setting in. As the condition worsens, feet may also begin to swell. Advanced trench foot often involves blisters and open sores, which lead to fungal infections; this is sometimes called tropical ulcer (jungle rot).

If left untreated, trench foot usually results in gangrene, which can cause the need for amputation. If trench foot is treated properly, complete recovery is normal, though it is marked by severe short-term pain when feeling returns. As with other cold-related injuries, trench foot leaves sufferers more susceptible to it in the future.

Tropical immersion foot

Tropical immersion foot (also known as "Paddy foot",^[1] and "Paddy-field foot"^[2]) is a skin condition of the feet seen after continuous immersion of the feet in water or mud of temperature above 22 degrees Celsius for two to ten days.^[1]^:27

Warm water immersion foot

Warm water immersion foot is a skin condition of the feet that results after exposure to warm, wet conditions for 48 hours or more and is characterized by maceration ("pruning"), blanching, and wrinkling of the soles, padding of toes (especially the big toe) and padding of the sides of the feet. Large watery blisters appear which are painful when they open and begin to peel away from the foot itself. The heels, sides and bony prominences are left with large areas of extremely sensitive, red tissue, exposed and prone to infection. As the condition worsens, more blisters develop due to prolonged dampness which eventually covers the entire heel and/or other large, padded sections of the foot, especially the undersides as well as toes. Each layer in turn peels away resulting in deep, extremely tender, red ulcerations. Healing occurs only when the feet are cleaned, dried and exposed to air for weeks. Scarring is permanent with dry, thin skin that appears red for up to a year or more. The padding of the feet returns but healing can be painful as the nerves repair with characteristics of diabetic neuropathy.

Foot immersion is a common problem with homeless individuals wearing one pair of socks and shoes for extensive periods of time, especially wet shoes and sneakers from rain and snow. The condition is exacerbated by excessive dampness of the feet for prolonged periods of time. Fungus and bacterial infections prosper in the warm, dark, wet conditions and are characterized by a sickly odor that is distinct to foot immersion.

^[1]^:27^[2]

References

1 2 3 4 James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
1 2 Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.

Consequences of external causes (T66–T78, 990–995)

Temperature/radiation	elevated temperature Hyperthermia Heat syncope reduced temperature Hypothermia Immersion foot syndromes Trench foot Tropical immersion foot Warm water immersion foot Chilblains Frostbite Aerosol burn Cold intolerance Acrocyanosis Erythrocyanosis crurum radiation Radiation poisoning Radiation burn Chronic radiation keratosis Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy Radiation acne Radiation cancer Radiation recall reaction Radiation-induced erythema multiforme Radiation-induced hypertrophic scar Radiation-induced keloid Radiation-induced morphea

Air	Hypoxia/Asphyxia Barotrauma Aerosinusitis Decompression sickness High altitude Altitude sickness Chronic mountain sickness HAPE HACE

Food	Starvation

Maltreatment	Physical abuse Sexual abuse Psychological abuse

Travel	Motion sickness Seasickness Airsickness Space adaptation syndrome

Adverse effect	Hypersensitivity Anaphylaxis Angioedema Allergy Arthus reaction Adverse drug reaction

Other	Electric shock Drowning Lightning injury

Ungrouped skin conditions resulting from physical factors	Dermatosis neglecta Pinch mark Pseudoverrucous papules and nodules Sclerosing lymphangiitis Tropical anhidrotic asthenia UV-sensitive syndrome environmental skin conditions Electrical burn frictional/traumatic/sports Black heel and palm Equestrian perniosis Jogger's nipple Pulling boat hands Runner's rump Surfer's knots Tennis toe Vibration white finger Weathering nodule of ear Wrestler's ear Coral cut Painful fat herniation Uranium dermatosis iv use Skin pop scar Skin track Slap mark Pseudoacanthosis nigricans Narcotic dermopathy

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