special subjects
Skin Care of the Residual Limb
Other skin problems
Ingrown hairs and folliculitis, although not dangerous, can cause substantial pain and discomfort. Not shaving the hair on the residual limb can help prevent these problems. Verrucous hyperplasiais a rare, serious skin condition of the distal tissues of below- and above-knee residual limbs consisting of rough, erythematous papules that coalesce to form plaques and warty bumps. It is caused by a combination of an ill-fitting prosthesis socket that compresses veins and lymph vessels, the loss of the normal venous and lymphatic return due to muscle contraction, and dependent edema of the distal stump. Verrucous hyperplasia is rare today because of improved socket design that incorporates distal/terminal compression of tissues to provide a back pressure. If the disorder does develop, patients should remove the prosthesis for a week and have socket fit adjusted, which typically corrects the problem within 2 to 4 weeks. However, this disorder can lead to serious infection if untreated. If bumps resembling warts appear, patients should immediately consult the prosthetist to have the socket adjusted. 