Hair Splinter? Is That Real??

I had a patient the other day come in with discomfort and a fluid filled lesion under his heel. He had gone to urgent care and was given an antibiotic. Nothing changed for him over the next few days and he followed up with me. Inspection of his heel sure enough showed fluid accumulation under the thick skin of the bottom of the heel. My recommendation was to release the fluid, and explore the skin beneath to see if he had stepped on something. X-rays were taken of course, and nothing was identifiable there. Once the skin was opened up and the fluid released, I noted a dark spot within, about the size of a pin-head. I was able to grasp it and pull it free. He indeed had stepped on something and it turns out, it was a black hair and also just so happens to have black dogs that shed. According to Podiatry Today, overlooking a foreign body is the second most common reason that patients file malpractice lawsuits against emergency room physicians. The problem is that Imaging modalities often do not pick up these types of injuries.  The penetration is thought to occur while wearing socks. The mesh of the sock actually holds the hair upright and keeps it from bending or breaking and then your repeated steps force the hair through the hard-plantar skin. This can happen to any pet owner and is seen commonly in barbers, hair salon workers and animal groomers. My advice is to always wear shoes and if you find that your pet hair is getting in there, make an effort to clean out the interior of your shoes

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