"When a patient comes to our office complaining of neuropathic symptoms, l recommend an Epidermal Nerve Fiber  Density biopsy (ENFD), which is now the standard to diagnosis small fiber neuropathy.  Studies have shown that most patients, especially diabetics with neuropathy, have small fiber neuropathy.   BAKO Pathology has made diagnosing and treating patients with neuropathy simpler.   An advantage of an ENFD biopsy, is that it is a safe and effective procedure performed in the office setting with results available within a week.  Another advantage to the ENFD biopsy is that the study can be used as baseline measurement and can be repeated in 6-12 months to compare the patient’s progress after initiating treatment.  I highly recommend that any doctor who is treating a patient for neuropathy obtain this test before starting treatment. "
Martha Ajlouny, DPM
Greensboro Podiatry Associates, P.A.

"Having used several pathology companies in the past, I now use Bako Pathology exclusively. Their reports are thorough, with a histologic picture of the sample, a diagnosis, and treatment recommendations based on clinical studies with references.  Patients are happy with the quick turn-around time and I have the confidence of knowing I have an accurate diagnosis and treatment plan.  BAKO provides excellent service and value to me as an individual practitioner, and as importantly, impressive financial support and educational services to our profession at large."
Melissa S. Hill, DPM 
Central Carolina Foot & Ankle Associates 
Durham, North Carolina

"Approximately 6 weeks ago a 70-year-old female presented to the office with a very atypical presentation of her plantar skin to both feet and irregularity to her toenails. She never had these problems until 4-5 months prior to her coming to see me.  She had previously gone to a dermatologist and had tried numerous medications and compounded medications without seeing any improvement in her nails and her feet.  The bottoms of both of her feet presented with peeling, redness and skin eruptions which was very uncomfortable for her.   The peeling and erythematous skin was quite impressive especially for sudden onset of a woman her age no history of dermatitis or skin problems.

I performed a biopsy which was positive for orthokeratosis of the skin and negative for fungus.  I started her on a regimen of Kera-HC and in 3 to 4 weeks time noticed dramatic improvement in the appearance of her skin.  She was very distressed and emotional about the appearance of her feet.  Now she is expressing great satisfaction.  Bako Pathology lab service was used and the Kera-HC product comes from their CTS line of therapeutic products."
Martha Ajlouny, DPM
Greensboro Podiatry Associates, P.A.

"During the past few weeks, I’ve had several atypical cases that I’ve had to have biopsied and sent to Bako Pathology Services.  In all three of these cases, the results were problematic necessitating further care.  I was able to contact the pathologist and promptly speak to the appropriate specialist about each individual case.   In one case in particular I had concerns about the outcome and Dr. Bradley Bakotic called me himself to discuss the case.  

The service at Bako Pathology Services I have found to be superior to other podiatric labs which I have used.    The pathologists take the time to inform and educate the clinician so through a comprehensive approach, great care is delivered to each patient."
Martha Ajlouny, DPM
Greensboro Podiatry Associates, P.A.

"I had a patient who picked up a very bad case of probable tinea pedis at Boy Scout camp last summer. He had seen some other doctors and tried various treatments without improvement. We performed a skin biopsy to confirm the diagnosis of hyperkeratotic tinea pedis, then used combination therapy including both Clarus Antifungal Cream and Kera-42 urea BID. At his 2 week follow-up visit the patient was doing great and thrilled to have finally gotten rid of what had been on ongoing problem."
Rob van Brederode, DPM
Alta Ridge Foot Specialists

Corns and calluses are thickened skin that develop to protect an area from irritation. They occur when something rubs against the foot repeatedly and causes excess pressure. If the thickening of skin occurs on the bottom of the foot, it's called a callus. If it occurs on the top of the foot, such as a toe, it's called a corn.
Kera 42 Cream is an effective and moisturizing urea-based cream for calloused, rough and dry skin. KERA-42 CREAM will exfoliate dead skin cells while restoring moisture and providing an optimal environment for healthy skin. Most of the over the counter creams are not capable of exfoliating the skin on our feet, and Kera 42 is excellent for exfoliating rough patches of skin on the feet. Our patients love this cream because they are seeing results right away and are pleased with how soft their skin feels and how healthy it looks.

Antifungal Solution:
Do you suffer from ugly, discolored and sometimes painful toenails? Toenail fungus, or onychomycosis, is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and smells foul. You may have a fungal infection that needs to be treated because, if ignored, the infection can spread and possibly impair your ability to walk. The more widespread the fungal infection is, the harder it is to treat. The staff at Greensboro Podiatry is using CLARUS™ Antifungal Solution, which is a safe, efficient and a very successful way to treat nail fungus topically. The vast majority of our patients are seeing results in as little as 3 months and are very pleased.

Macerated Web gel:
Athlete's foot is a skin disease caused by a fungus, usually occurring between the toes. The fungus most commonly attacks the feet because shoes create a warm, dark and humid environment which encourages fungus growth. Athlete's foot may spread to the soles of the feet and to the toenails because organisms that cause athletics foot may persist for long periods. MacerRx Web Gel is a safe, fast drying gel used to treat macerated and infected web spaces.
N’tuma Jah, DPM/Greensboro Podiatry Associates

"I had a patient who picked up a very bad case of tinea pedis at Boy Scout camp last summer. He had seen some other doctors and tried various treatments without improvement. We were able to biopsy the skin and find that he had tinea. We used a combination of treatment with Clarus Antifungal Cream and Kera-42 Cream BID. By the 2 week follow- up the patient was doing great. He was thrilled to finally get rid of the ongoing problem. "
Rob van Brederode, DPM
Alta Ridge Foot Specialists

"It is my opinion, based upon 26 years of clinical experience, that tissue biopsied from the sole of the foot looks different than biopsies taken from other non-weight-bearing parts of the body. I have spoken with numerous pathologists who agree with this premise. With that being said, I want someone who is experienced with processing and examining tissue taken from the foot looking at my pathology specimens. Such podiatric expertise exists at Bako Pathology. I have been consistently happy with the results I recieve from Bako. If there is a question on their end with the specimen they call our office. If we have a question with a requirement for a special stain or a handling issue they are happy to take our call and give us the answer in a timely manner. The references included on the pathology report are excellent points of information for those "google minded" patients. In those situations when the pathology result is a diagnosis of a melanoma or some other cancerous lesion the pathologist calls personally. That personal customer service has made Bako my preferred pathology partner. "
Phillip E. Ward, DPM
Central Carolina Foot and Ankle Associates
Durham, NC

"Hey Brad! Just days after leaving the Bako fellowship, I saw a patient with a lesion on the dorsal left foot that was asymmetrical, hyper-pigmented centrally, and had irregular borders.  I asked the doctor I work with about doing a biopsy of the skin lesion as a precaution, and we did.  The results came back as a lentiginous malignant melanoma.  Had I not attended the fellowship, I would not have paid much attention to the lesion, especially when the patient attests that she never bothered to pay it any mind.  It felt amazing to be the beginning step to her journey in eradicating such dangerous skin lesion.  You still won't imagine how much you've impacted my life, and I'll be forever indebted to you.  I hope that the move went well, and I pray for the lab's continued success.  You helped me save someone’s life!  I can’t repay you, so for now on her behalf and others I encounter in the future, let me thank you.  "
Best regards,
S. Davis, DPM

 "It is refreshing to be working with Bako Pathology, a lab that is dedicated to podiatric pathology. It does not stop there. They are strongly dedicated to promoting our profession through education, research and financial support. It's a delight to see internet-based reporting and 24 hour turn-around time. Their web site is user friendly and easy to order supplies. The reports are detail-oriented, with therapeutic options and literature references. It is supplemented with excellent digital photomicrographic imaging. Keep up the great work... "
Allen Lazerson, DPM
Past president GPMA

"Bako Podiatric Pathology Services should be your first choice for all your pathology needs because Bako provides state of the art facilities and exceptional and responsive client services. Even more important, Brad Bakotic, DPM, DO is the only DPM in the world who is certified in anatomic pathology and dermatopathology. This matters to you and your patients."
Bryan C. Markinson, DPM
New York, NY

"The easiest part of switching to Bako Podiatric Pathology Services was knowing that customer service for the Doctor and the Patient is a top priority. The Dermatopathologists are knowledgeable and friendly and the support staff always seems eager to help. Reports are timely and clinically helpful. Even though Bako is a new Pathology Lab, they have demonstrated an unequaled level of dedication to the Podiatric profession. "
Bob Warkala, DPM
Sewell, NJ

Today we had a patient come in who has been using the Kera42 cream for about a month. She has been undergoing chemotherapy and, as a result, has been dealing with dry, cracked, peeling skin since shortly after these treatments began. There had been several times where she had to trim large pieces of peeling skin off of the bottom of her feet and palms of her hands. After less than a month of using the Kera42 cream, her skin has been completely rejuvenated and is no longer peeling or dry. She says she has been extremely pleased with the outcome.
Dr. James Shipley
Mt. Airy, NC

"The doctors and staff in our office loves to work with Bako Podiatric Pathology Services. They make it simple for staff to send them specimens, their reports look great, are descriptive and easy to read. We have found the Pathologists to be above the curve with their acute diagnosis and most impressive is their willingness and availability to always get on the phone to discuss a case. "
Hal Ornstein, DPM, FAPWCA
Managing Partner
Affiliated Foot and Ankle Center, LLP 

Howell, New Jersey

"I use Bako Podiatric Pathology Services not only because the results are accurate, detailed, and timely, but also because Drs. Bakotic and Hackel are approachable and always willing to go the extra mile to help me to accurately diagnose both complicated and everyday skin conditions. They are always just a phone call or email away. Their availability helps facilitate a quick diagnosis and treatment plan so that my patients get better faster. "
Chad Webster, DPM
Memphis, TN

"From beginning, to receiving my pathology results, my experience with Bako Podiatric Pathology Services has always been convenient, quick and seamless. Punch, shave or clip, drop the specimen in the jar and you’re done. Return reporting is quick, fax copies of the results are sent followed by a hard copy in the mail. Recently, I have been accessing my reports on their web portal. The reports are clear and to the point. Suggested treatment plans based on podiatric outcomes accompany the diagnosis. A very clear photograph of the histological slide is included on the report as well. Lastly, and perhaps most importantly, if you have any questions regarding the results or the condition the doctors at Bako are always available. Personal service, rapid response time, easy to use I feel that the doctors and staff at Bako are part of our office family. "
Bruce Lashley, DPM
New York, NY

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