Before treatment (above). This patient had polio as a child & spent much of their adult life in a power wheelchair. They had recurring leg wounds & infections. They had lymphedema (secondary to limited leg movement – not using their muscle pump, having had multiple orthopedic leg surgeries – causing scarring to lymphatic vessels, developing likely undiagnosed venous insufficiency – given their repeated wounds & the rise in tissue pressure when legs are in a dependent position, infections – causing lymphatic scarring). Their toes have a cauliflower-like appearance. This is papillomatosis. They also have small lobules that developed on top of toes creating grooves. The uneven surfaces create a safer harbor for bacteria to grow.Approaching the end of treatment.
