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A Problem of the Homeless in the 1990s

Keith Wrenn, MD

Arch Intern Med. 1991;151(4):785-788.

Abstract
The syndrome of immersion foot is being seen with increasing frequency among the homeless population. It represents the effects of injury by water absorption in the stratum corneum of the skin of the feet. The taxonomy of this disorder is confusing and the many colorful pseudonyms should probably be dropped in favor of a simple classification based on the temperature of the water and the duration of exposure. When uncomplicated by infection or ischemic injury, immersion foot will quickly resolve with conservative measures only. More complicated cases may require antibiotics and surgical treatment. This syndrome may be exacerbated by disturbances of cognition, peripheral neuropathy, peripheral vascular disease, or the use of tobacco or vasoconstrictor drugs such as cocaine. A major contributing factor seems to be lack of shelter in the homeless population. Attention to foot care problems among the homeless and education concerning preventive measures are incumbent on physicians who care for the indigent.

(Arch Intern Med. 1991;151:785-788)

Author Affiliations
From the Grady Memorial Hospital and the Emory University School of Medicine, Atlanta, Ga. Dr Wrenn is now with the Department of Medicine, Strong Memorial Hospital, Rochester, NY.

Footnotes
Accepted for publication June 4, 1990.

Reprint requests to the Department of Medicine, Strong Memorial Hospital, 601 Elmwood Ave, Rochester, NY 14642 (Dr Wrenn).

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