Thursday, October 19, 2017

Visiting The Bata Shoe Museum

This past week while on vacation, my wife and I visited the Bata Shoe Museum in Toronto, Canada.  As a podiatrist, I am acutely aware of the shoes my patients wear, so naturally, I thought a trip to the shoe museum would be an interesting diversion.
We were not disappointed.  The museum provided a rich account of, not only the various types of shoes worn around the world and through the ages, but also how footwear was influenced by culture, tradition, art, history, religion, the elements, and yes, style.  From practical to the improbable, the shoes from various regions and time periods provided great insight into their respective cultures.  Examples of displays ranged from primitive grass lined shoes, women's shoes of ancient China, waterproof seal intestine boots of Inuits, boots worn on the moon and platform shoes of rock stars from the 70's.
Although an interesting experience, my wife and I are both grateful to have been born in the time and place we were!

Evan Kelner DPM


Saturday, September 9, 2017

Plantar Warts

Plantar warts, or warts on the bottom of the feet, are a very common condition.  They are also known as verrucae, and are caused by a DNA virus.  Warts usually affect young people and are often brought on by stress.
They are found on the bottom of the foot.  Plantar warts present as round, hard lesions of thickened skin.  They can be easily mistaken for corns, foreign bodies or plugged up sweat glands.  Warts have their own blood supply, so when picked at or cut, they often bleed.  Depending where on the foot it occurs, the area can be painful with walking or standing.
Warts can be very difficult to resolve, and thus there are many treatments.  Some of the methods used are burning the wart out, freezing it, acid applications, oral treatments and excising it.  If left alone, the wart may grow in size and become even more difficult to resolve.
If you, or someone you know, has what may be a wart, see a professional.  Our office takes pride in becoming part of your health team.  We always stress preventive care and explore conservative treatments first.
We are located at 1398 Highway 35, Ocean Township and 191 Highway 37 W, Toms River.  We can be reached at (732) 988-0070.,

Thickened Toenails - Fungus or Not ?

Often a patient presents to my office complaining of thick fungal toenails.  But is it really a fungus ?  Most people are aware that thickened, darkened toenails often mean fungus of the toenails; a condition called onychomycosis.  However, trauma to the toenail, even seemingly minor trauma, can also cause the toenail to become thick and darkened.
Onychomycosis can be caused by one or more types of fungus, causing the nail to become thickened, darkened, and with hard tissue under the toenail.  Treatment consists of either oral or topical medications.  Resolution is slow, even with the most effective treatments.
If the thickened toenail is caused by trauma, conventional fungus treatments won't work.  Thickened or dystrophic toenails may be caused by direct impact trauma, such as dropping a heavy object on the toe.  Sometimes microtrauma can cause damage of the toenails.  This is mild repetitive trauma that is often associated with stop and go actions, causing the toenail to rub on the sneaker.  This is common with runners, basketball players, and tennis players.  A substance, called keratin, forms under the toenail, causing it to become thickened and dark, mimicking onychomycosis.
The only way to definitively make a diagnosis is with a nail culture, which is analyzed by a lab.
If your toenails are thickened, darkened and uncomfortable, call us today. We can diagnose the problem and give you fast relief.  Our offices stress preventive foot health, especially for at risk patients with diabetes and poor circulation.  We are located at 1398 Highway 35, Ocean,and 191 Highway 37 W, Toms River.  We can be reached at (732) 988-0070 or (732) 286-9200.  For more information , log onto our website at

Thursday, August 10, 2017


Recently, I have been seeing many cases of gout in my office.  Gout mainly affects men and post-menopausal women.  Gout usually occurs within the joint of the great toe, but it can occur in many other joints of the foot and ankle.  Gout is characterized by pain, swelling, redness, inflammation and burning. All pressure to the area and all walking can be extremely painful.
Gout is caused by excessive uric acid, which accumulates in the affected joint.  The excessive uric acid is brought on by either over production or under excretion of uric acid in the urine.  Certain rich foods and alcohol can precipitate a gout attack.  Such foods and alcohol may include red meat and their extracts, such as gravies and soups, shellfish and port wine.
If gout is treated within the first 24 hours of an attack, colchicine would be the drug of choice.  If gout has been present for more than 24 hours, a non-steroidal anti-inflammatory drug such as indomethacin is commonly used.  Steroid injections to the area often alleviates much of the pain.  After the initial manifestation of gout, your medical doctor may prescribe medication to prevent future attacks.  If untreated, multiple episodes of gout can severely, and permanently, damage the joint, causing arthritic changes.
If you experience a red, painful joint in your foot, do not ignore it .  Contact a podiatrist or your primary care doctor as soon as you can.

Evan Kelner DPM
(732) 988-0070

Monday, May 29, 2017

 Is That Mole Dangerous?

The most dreaded finding in a Podiatrist office is the detection of malignant skin lesions. There are a few different types of skin cancer, most with little chance of spreading or metastasizing. By far, the most dangerous kind of skin cancer is malignant melanoma.
Melanoma is believed to be caused by excessive sun exposure.  Unfortunately, this even includes exposure from decades before.
Although extremely rare in the foot, everyone should be aware of the signs of malignant melanoma.  Characteristics of a melanoma are lesions that have changed color, shape or size. Also, any lesion that has started bleeding for no apparent reason should be considered suspicious. Areas where this can occur are not always in plain site.  Be aware of changing lesions of the toenails or between the toes.
If something on the skin does not seem right or has changed, see a dermatologist, or a podiatrist, if it is on the foot.  The doctor will perform a skin biopsy, taking a small sample of the area, that will determine the nature of the lesion.
The best way to treat a melanoma is to detect it early.  Don't could save your life.
If you have a suspicious mole or lesion on your foot, please contact our office for an examination as soon as you can.

Evan Kelner, DPM

Thursday, April 27, 2017

Treatments For Fungus Toenails

One of the most common complaints seen in any podiatrist's office is the problem of fungus toenails or onychomycosis.  This is also one of the most frustrating conditions for not only the patient, but for the treating doctor also.  Success in treating onychomycosis has been elusive. Even with successful treatment, re-infection is common.
Unlike skin fungus, fungus of the nails is deep within the toenail, and thus it is difficult for a topical medication to reach it.  Most of the older topical medications and over the counter medications have been proven to be ineffective.  Home remedies are widely used, but I have not seen much improvement with them in my practice.  Newer prescription topical medications such as Kerydin and Jublia are much more effective in treating onychomycosis.  These medications must be applied to each affected toenail daily for at least 9-10 months.
The most effective way of curing onychomycosis is with oral medication.  Lamisil has been used for many years and is still considered the gold standard.  The concern with Lamisil therapy is that, in a small percentage of people, the liver enzymes can be affected.  It is for this reason that blood tests are required both before and during the three month course of treatment.
There is a new drug for onychomycosis currently awaiting final approval by the FDA.  This drug is called Viamet.  The exciting aspect of this drug is that it does not affect the liver.
With new medications on the horizon, the prospect of getting rid of toenail fungus has never been better.
If fungus toenails are a concern, please call us so we can explore the possibilities of an effective treatment.

Evan Kelner DPM

Saturday, April 15, 2017

 Ingrown Toenails

One of the most common conditions seen in a podiatrist's office is the ingrown toenail.  An ingrown toenail is a condition in which a side of the toenail grows into the flesh.  This can be a painful condition, both with and without pressure to the area.  If ignored, the toenail border can penetrate the skin, causing a bacterial infection.
Ingrown toenails are mostly a hereditary condition.  The toenail generally follows the shape of the bone beneath it.  Ingrown toenails can also be caused by improper cutting of the toenails. The condition may be exacerbated by wearing tight shoes.
Soaking the area, followed by dressing changes, may temporarily slow the progression, but ultimately, the ingrown portion of the toenail must be cut out.  This should be done by a podiatrist. If there is an infection, local anesthesia may be needed.
If the problem becomes recurrent, a permanent removal of the ingrown part of the toenail can be achieved by a simple office procedure.  A chemical is used to destroy the cells that make only that part of the toenail grow.  No sutures are needed.  Normal skin soon fills the area and there is an acceptable cosmetic result.

                                Some Tips for Preventing Ingrown Toenails:

1) Always cut toenails straight across or along the contour of the toenail
2) Do not dig into the ingrown toenail or perform "bathroom surgery"
3) Avoid tight restrictive footwear.

If you have an ingrown toenail, seek attention as soon as you can.  They tend to get worse as time goes by!

Evan Kelner DPM