LUPUS is a chronic inflammatory disease that occurs when the body’s immune system attacks it’s own tissues and organs.

This condition is often hard to diagnose because its signs and symptoms mimic those of other ailments.

In most cases the cause of lupus is unknown, but triggers can be sunlight, infection and certain medication.

Lupus is more common in women and is often diagnosed between the ages of 15 and 40. It is found more in people of African, Asian and Hispanic descent.

Foot problems in lupus patients can involve any of the tissue structures within the foot. Joint problems can lead to bunions, claw toes and hammer toes. Other problems include:

•Vasculitis (blood vessel inflammation);

•Peripheral vascular disease;

• Oedema (swollen feet);

• Drug therapies;

• Peripheral neuropathy;

• Raynaud’s syndrome;

• Tendonitis;

• Myositis (muscle inflammation);

• Nail dystrophies, including hollow nails that are pitted and ingrown;

• Jaccoud’s arthropathy (a type of arthritis);

•Hyperkeratosis (callused thick skin); and

•Corns and callus due to the mechanical stresses and dysfunction.

Patients tend to feel pain more intensely than the average person when they have lupus. The greatest concerns for the podiatrist are the vascular complications, as these can lead to slow, painful healing and gangrene.

Treatment

The key aim in the treatment of the unstable lupus foot is the prevention of serious complications, reducing pain and increasing mobility.

Regular foot assessments are essential. Patients are advised regarding hygiene and the correct footwear with the provision of orthotic insoles, if necessary.

Treatment may involve the aseptic reduction of corns and callus with padding added to reduce stress.

Correct nail care is vital. It is advised that patients with lupus should only be treated by a medical professional and not a nail technician.

Despite the high risks, lupus patients usually respond well to carefully planned and supported intervention for foot mobility.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974- 6339), Kingston (978-8392), and Savanna-la- Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.