Lower-Extremity Skin Care Among Unsheltered Patients: Findings from Miami Street Medicine

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Introduction Unsheltered homeless (USH) individuals’ main mode of transportation is by foot and any trauma, injury, or disease affecting the lower extremity can greatly affect their ability to complete activities of daily living, such as finding food and shelter. The Miami Street Medicine (MSM) team conducts weekly mobile clinics and has noticed large numbers of foot complaints among unsheltered patients. Methods: USH patients were interviewed and evaluated during weekly clinics between April 2021 and January 2022. After assessing relevant medical history, their chief concerns were addressed. Patients with foot concerns were evaluated and provided protective footwear, socks, and hygiene supplies. Results: Tinea Pedis (TP) was encountered frequently in approximately 26.8% of patient care instances. Powder-based antifungals were provided for most (75%) of TP cases. Onychomycosis and dystrophic nails were often seen alongside TP infections. Foot (29.3%) and leg (17.1%) ulcers were seen mostly in patients with a history of diabetes. Socks have been the most requested and distributed item of clothing at MSM clinics, with over 400 pairs distributed in 8 months. Low-cost measures such as socks and antifungal powder can provide subjective relief and partially manage symptoms.


  • Taha Rasul, BS, Medical Student, University of Miami Miller School of Medicine