Case Studies

Efficacy of a Skin-Protective Mousse in Patients with Diabetic Foot
Conditions
Christian Holubarsch, MD.

Background: 
Diabetic foot conditions are well known as one of the concomitant complications in diabetes
patients, even though they most often are neglected. In the initial stage roughness of the skin
especially on the sole of the foot can be observed together with hyperkeratosis, rhagades and
fissures as well as mycotic skin in various appearances. Only in advanced stages typical
diabetic foot ulcers occur. Usefulness of agents, topically applied in a preventive or protective
intention has been generally unsatisfactory.

Objective:
To determine if diabetic foot conditions in their initial stages could be improved by the use of
Footlogix, a protective mousse containing urea and/or clotrimazol an observational study was
initiated.

Methods:
After photo documentation and an initial examination by both, the investigator (head of
diabetes clinic, MD) and a medical Podologist (mPOD) the study mousse was given to adult
male and female subjects with known diabetes mellitus and the above described initial stage
of diabetic foot syndrome for routine application. At 2 and 4 weeks the skin was evaluated by
the investigator and the mPOD for the parameters including roughness, hyperkeratosis,
fissures, rhagades and signs of mycosis on a numerical scale. Pictures were taken at each
visit. A global evaluation was also performed. No other topical appliances were used;
changes in systemic therapy were made following the needs of the patient’s metabolic status.

Results:
Twenty subjects were enrolled in the study, with 8 completed to date. On a 0-5 scale the
physician's and the mPOD’s initial global evaluations averaged 4.0 and 4.5, respectively. The
final scores were 4.2 and 4.5, on the average. All subjects had improved over the course of
the study. No adverse effects were noted.

Conclusion:
This Footlogix protective mousse greatly improved typical initial diabetic foot conditions in a
sizable number of individuals, especially if previously uncontrolled. In two persons, a longterm
observation is available with excellent result

Copyright © 2008 by Prof. Dr. med. Ch. Holubarsch, MD

CASE STUDY # 1

Background – The Subject is a 38-year-old male property manager who has Type 1
Diabetes and is very over weight. His has a high-stress job and he admits to not taking
very good care of himself. He does not exercise or eat properly, but is trying to change this
behavior by visiting a swimming pool. He also admits to going bare foot at the pool.
Subject finds walking painful, at times.

Initial Condition – Very thick, dry, cracked skin on plantar surface and around the edges
of his heels, having several of these fissures occasionally bleed. One of the worst cases of
thick callused and cracked skin I have ever seen. It was suspected that this subject also had
a skin condition called Tinea Pedis (fungus of the skin of the foot), both from going bare
foot at the pool and because of his diabetes. Subject has never had his feet looked at or
treated by anyone in the Footcare industry.

Recommendation – Subject was prescribed Footlogix Cracked Heel Formula (3Extra) to
be used every night for the first 4 weeks. It was also recommended to the Subject to have
regular foot care (every 4 weeks) and to actively pursue a lifestyle change and to wear
water slippers at the pool.
After the first 4 weeks, the Subject returned with some improvements. At this time,
another foot care service was completed with a slight removal of dry skin on the plantar
aspect of both feet. Subject was then prescribed Footlogix Anti-Fungal (7) in the morning
and Footlogix Cracked Heel Formula in the evening.
After another 4 weeks, the Subject returned for his next foot care treatment with callus
debridement and much improvement was exhibited on his feet.

Results – As demonstrated by these pictures, in 16 weeks, the Subject exhibited
remarkable results.

Conclusion– Subject needed proper skin care and foot care on his feet. By using the
correct Footlogix mousse and following a proper foot care routine, this gentleman obtained
fantastic results.

Conducted by - Vicki Malo, BScPod, Certified Podologist
Case study completed from Nov 06 to Jan 2007

CASE STUDY # 2

Background – The Subject is a 45-year-old female office worker, with a high stress job,
who works out occasionally and admits to poor eating habits. Her usual footwear is high
heels at work and flip-flops for casual and at home.

Initial Condition – Dry flakey skin around lateral edge of heel. Subject has been using a
greasy cream for last 6 months with no results. It was suspected she had a skin condition
called Tinea Pedis (fungus of the skin of the foot) which was part of the reason why she
was not achieving the results she was seeking.

Recommendation – Subject was prescribed Footlogix Dry Skin Anti-Fungal Formula
(7Extra) once per day for the skin of her feet, Footlogix Shoe Deodorant spray with anti-fungal
properties for her shoes and it was also suggested she stop wearing flip flops as
often.

Results – Subject returned 2 days later with the below results.

Conclusion – Prior to initial consultation, the Subject had previously been recommended to
treat the dry skin using greasy creams. Because the condition was more than just dry skin,
this recommendation was not working. However, upon using the Footlogix Mousse for dry
skin with anti-fungal properties, she obtained the results she desired in only 2 days.

Conducted by - Vicki Malo, BScPod, Certified Podologist
Case study completed on March 27, 2007

CASE STUDY #3

Background – The Subject is a 36-year-old female hairstylist. Because of her career, she
is standing on her feet all day and admits to at times, wearing impractical shoes with a very
narrow toe box.

Initial Condition – Subject presents with lifting of the great toe of the right foot. The
toenail is lifted over half way down the nail plate with debris between the nail plate and
bed. It is suspected she has onychomycosis (nail fungus).

Recommendation – Subject was prescribed Footlogix Nail Tincture (7 S) to spray under
her nail twice daily for the first 3 weeks, then once a day until the nail grew out. It was
also suggested she start wearing proper footwear when working, and cutting her nails
regularly.

Results – Subject returned on a regular basis to take pictures of the good results. She did
not receive any foot care, and had the nail cleaned out on the 3rd visit.

Conclusion – Subject achieved great results by using the Footlogix Tincture without the
need for any other foot care treatment, like cutting down the nail or cleaning out the debris
every few weeks.

Conducted by- Vicki Malo, BScPod, Certified Podologist
Case study completed from Dec 06 to April 2007

CASE STUDY #4

Background – The Subject is an obese 40-year-old African American female working as a
receptionist. She does not practice much foot care but does apply hand cream to her feet
after showering. She usually wears shoes that are sloppy and too big for her feet. Subject
admits to going bare foot whenever possible. She also complains that the dry skin on her
feet snag and catch on her bed sheets.

Initial Condition – Dry, rough skin around the perimeter of the heel and along both sides
of the foot including the great toe. Because Subject goes bare foot, it is suspected she has a
skin condition called Tinea Pedis (fungus of the skin of the feet). Both feet presented with
the same condition.

Recommendations – Subject was prescribed Footlogix for Dry Skin Anti-Fungal Formula
(7 Extra) to be used twice daily, as well as Footlogix Shoe Deodorant spray with antifungal
properties for her shoes. It was also recommended she no longer go bare foot.

Results – Subject applied Footlogix Mousse (7 Extra) to one foot twice daily for 2 days
with the below results.

Conclusion – Subject was not seeing results from using the hand lotion, as it was too
greasy to be absorbed into the skin and because the condition itself was more than simple
dry skin. However, after using Footlogix Mousse for dry skin with anti-fungal properties,
she achieved great results in only two days.

Conducted by - Vicki Malo, BScPod, Certified Podologist
Case study completed on Jan 10, 2007

CASE STUDY # 5

Background – The Subject is a 61 year old nurse working in ICU. She does wear proper
shoes for work, however complains of tired aching feet and admits to wearing Birkenstocks
when not at work. Lifestyle is fairly healthy, but has work related stress. She has been on
long term estrogen for hormonal fluctuations.
Initial Condition – Subject presented with dry rough skin around the perimeter of the heel,
the lateral edge of the foot and the medial aspect of the great toe. Because of long term
medication and work related stress it is suspected the subject has Tinea Pedis (fungus of the
skin on the feet).

Recommendations – Subject was prescribed Footlogix for Dry Skin Anti-Fungal Formula
(7 extra) in the morning, Footlogix Tired Heavy Leg Formula to be used in the evening,
and Footlogix Shoe Deodorant Spray with anti-fungal properties for her shoes. Monthly
pedicures and foot massage were also recommended.

Results– Subject applied the Footlogix Mousse (7 Extra) every morning for 5 days with
the below results.

Conclusion – Subject cut down on wearing the Birkenstocks, and used the Footlogix # 7
Extra Mousse daily, because condition was more than dry skin, she achieved great results.
However with the long term medication she will need to continue using Footlogix Mousse.

Conducted by – Vicki Malo, BSc Pod, Certified Podologist
Case study completed on February 18, 2008

Case Study #6

Background – The subject is a 25 year old male working in a warehouse. Footwear is
mostly running shoes. Subject presents as underweight, has an active lifestyle and is a
moderate smoker.

Initial Condition – Subject presented with very dry rough skin on the back of heel and
plantar aspect of heel. Because of lifestyle and nature of the skin, it is suspected subject
has a Tinea Pedis (fungus of the skin on the foot).

Recommendation – Subject was prescribed Footlogix for Dry Skin Anti-Fungal Formula
(7 Extra) to be used both am and pm. Footlogix Shoe Deodorant Spray with anti-fungal
properties was recommended for the footwear. Subject was also advised to alternate his
footwear daily and the wear natural fiber socks.

Results – Subject applied the Footlogix Mousse (7 Extra) twice daily for 4 days with the
below results.

Conclusion – The subject applied the Footlogix Mousse #7 Extra twice daily, and has
received great results, by recognizing the condition as more than dry skin and by using the
appropriate product the dry rough skin is decreased in a very short time frame.
Examined by – Vicki Malo, BSc Pod, Certified Podologist

Conducted by – Angela Di Corso, Apprentice
Case Study completed on January 25, 2008

CASE STUDY #7

Background – The Subject is a 50 year old CEO. Because of her career, she is at times
standing on her feet all day and admits to wearing impractical shoes with a very narrow toe
box.

Initial Condition – Subject presents with lifting of the great toe of the right foot. The
toenail is only lifted in the lateral corner. It is suspected she has onychomycosis (nail
fungus).

Recommendation – Subject was prescribed Footlogix Nail Tincture (7 S) to spray under
her nail twice daily for the first 2 weeks, then once a day until the nail grew out. It was
also suggested she start wearing proper footwear when standing for long periods, and
cutting her nails regularly.

Results – Subject returned in two weeks with these phenomenal results.

Conclusion – Subject achieved great results by using the Footlogix Tincture without the
need for any other foot care treatment, like cutting down the nail or cleaning out the debris.

Conducted by- Vicki Malo, BScPod, Certified Podologist
Case study completed from January 24 08 to February 7 2008