Welcome to the personal website of

Dr. Michael A. Zapf, DPM, MPH, FACFAS, FACFAOM

Thank you for visiting the web site of Dr. Michael Zapf. He is a member of the Agoura-Los Robles Podiatry Centers

The "real" practice web site, the one that contains registration forms, doctor information for all the office and directions to the office is located at:

www.conejofeet.com   ç Click here

I am Dr. Michael Zapf. I have been offering a full range of podiatric medical services, from ingrown nails to heel pain and foot surgery, to my friends and neighbors in the Las Virgenes, Conejo and Simi Valleys since 1985. This is my personal web site. It has been up since 1990 and has received more than 2 million visits. The entire site is my responsibility only and nearly everything on the site was written by me. You are welcome to peruse this site and learn what you can about me, your feet and the problems your feet can develop. Things happen fast in medicine so whatever you read could well be outdated, especially if it was written many years ago. On this site you will read historic articles that I wrote for a lay audience as long as 25 years ago, so please do not take anything on this site as definitive or as applying directly to your condition. You may wonder why I have my own site even though there is also an official practice site. Well, my partners are of a younger generation raised on tweets, e-mails and iPhones. They want a professional site that they believe better represents the professional nature of our practice. They also believe that people no longer take the time to read anything of length. I, on the other foot, think there is still a world out there full of people who still read lengthy descriptions of problems and solutions. if you are one of those old fashioned readers, then this site if for you. Let me know what you think. Let me know you are out there.

Please note that all information and photographs on this site are copyrighted by me, Michael Zapf, DPM, and cannot be used for any private or commercial purposes. I work with two other podiatrists in my practice who may or may not share any of my ideas and philosophy. Do not expect them to practice the way I do or even believe in any of the speculation I present here. If you appreciate what I have written and want me to be your treating doctor, you will have to ask for me specifically. Even if my office says at first, " He is booked until next month",  I still want to see you as long as you are a little flexible with your schedule. If your visit is an emergency, I know that  you will be happy with either of my associates, Dr. Darren Payne or Dr. Steve Benson. They are exceedingly well trained and capable in any foot emergency.

Michael Zapf, DPM, MPH, FACFAS, FACFAOM     (If you want to know what all those initials mean, click here   è  

Our office phone number is (818) 707-3668 and my e-mail address is zfootdoc [at] doctor [dot] com

Agoura Hills Office: 28240 Agoura Road, Suite 101, Agoura Hills, CA 91301

Thousand Oaks Office: 555 Marin Street, Suite 290, Thousand Oaks, CA 91360

For the address, hours and registration forms please see the practice web site: www.conejofeet.com

07/24/2010

To Order Foot Supplies è ç click

For Information about Laser Treatment for Fungal Nails Click hereè
 

For information about Shockwave Therapy for heel pain          click here è

Exciting news!!! New Thousand Oaks Location  è

<--- This is a picture

of the bottom of the right foot of a patient with two little seed corns that are also called porokeratotic lesions or plugged sweat ducts. Note that the seed corns seem to occur in the middle of a more typical and regular callus. They seem to be a specialized callus. Whatever they are called they are aggravating. They grow into a second little callus that feels like you are walking on a little grain of sand or rice. When you pick at them you often get a little piece of skin from the center that people sometime mistake for a "seed", hence the name. When the seed comes out you are under the wonderful delusion that you have gotten the center of the lesion and you are done with the thing. Wrong-O! the thing is still there and continues to grow and cause complications.

1.   2.

The left picture is a photograph of another patient with a little seed corn (porokeratotic lesion) on the bottom of the right foot. The second picture (2) shows it in close-up. It is called a seed corn because picking at it with a fingernail often results in the removal of a little piece of keratin that tends to make people think in unfounded optimism "I've gotten it our at last." Sorry, but you haven't. We will see you in the office. 

Why they even develop is still a mystery. The best guess is they are a special type of callus. In fact they seem to develop in calluses. In the case pictured it is developing in a linear callus running between the first and second metatarsal heads of the foot. Look closely and you will see two separate seed corns in the long callus.

They are called plugged sweat ducts because of the mistaken notion that an underlying sweat duct must be plugged. Rumor has it that some researcher found a sweat gland under a lesion when looking at it with a special electron microscope (and you thought your job was boring). Later research has never verified this finding and the name is probably an anomaly.

Treating The Aggravating Little Monster (ALM)

Treatments for a porokeratotic lesion are as follows:

1. Ignore it! This is a benign lesion that can be safely ignored if it does not cause any harm and doesn't hurt. It does not "need" treatment just because it is there.

2. Wear comfortable shoes and socks. If wearing padded shoes and socks keeps the ALM from hurting, then go for it. Ask at the office for our list of shoe recommendations.

3. Trimming the lesion. In the office I can make these guys stop hurting for weeks (sometimes many weeks or months) by just trimming the lesion with a sharp scalpel blade.

4. Padding the lesion. Putting a pad around the lesion will protect the ALM and frequently keep it from hurting. Putting a pad on the lesion is a natural thought when something hurts but avoid that; put the pad around the lesion. In the office I use an "aperture" pad made of felt with a circle cut into it. Putting the  pad around the lesion makes it feel much better.

5. Removing it surgically. Sometimes an attempt will be made to remove the ALM under local anesthesia using a scalpel blade and a tool that I call a "melon baller for ants" (technically a curette) that scoops the lesion out of the skin. While it works great for warts, for a known sweat duct this is not a highly productive maneuver. It permanently removes the ALM only 10-20% of the time. This is a great technique for a "suspected" porokeratosis. With this technique you can remove foreign bodies like glass or pet hair (really! - pet hair from short haired dogs and cats can actually work its way into the skin). If this is really a wart masquerading as a seed corn, it will also remove it.

6. Sclerosing: I an one of the few people who use a technique to kill off seed corns with a series of injections. I have lectured to this technique to other podiatrists a number of times. Just under the skin I place 4% alcohol solution in anesthetic solution. This is more fully described under the section called sclerosing. Click the green word sclerosing to go to the sclerosing page - SCLEROSING!

7. Surgical removal using two completely through the skin incisions is 100% effective but has a risk of permanent scarring. To reduce the scarring you should stay off of your feet for 2-3 weeks (crutches!). Needless to say this is the least common method of treating a seed corn. 7. Surgical removal using two completely through the skin incisions is 100% effective but has a risk of permanent scarring. To reduce the scarring you should stay off of your feet for 2-3 weeks (crutches!). Needless to say this is the least common method of treating a seed corn.

Send mail to (zfootdoc at doctor dot com) with questions or comments about this web site.
Copyright © 2000 Michael A. Zapf, D.P.M., F.A.C.F.A.S., F.A.C.F.AOA.M.
Last modified: July 24, 2010