[42F] With chronic foot pain and dermatological symptoms

Patient Description

A 42-year-old female reports experiencing sharp pain in her foot when pressure is applied, persisting for a few years. She suspects it may be related to athlete's foot. The symptoms include a persistent odor between the toes and intermittent clear liquid-filled bumps that itch, occurring every few months. The patient has not had any recent injuries or exposure to communal areas like gyms or pools. She primarily wears mud boots or tennis shoes and has not tried changing footwear or using moisture-wicking socks. Antifungal treatments have been used for over a year, providing some relief for the odor but not for the calloused skin. The patient has no known chronic illnesses, no history of diabetes, and no known allergies except for aspirin, which causes hives. She is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Athlete's Foot (Tinea Pedis): This is a common fungal infection that affects the skin on the feet, often between the toes. Symptoms can include itching, burning, cracked, and peeling skin, as well as blisters that may ooze. The odor and persistent nature of your symptoms align with this condition.

    • Treatment typically involves antifungal creams, powders, or sprays. In more persistent cases, oral antifungal medications may be necessary. It's important to continue treatment for the full recommended duration, even if symptoms improve, to prevent recurrence.

  • Dyshidrotic Eczema: This condition can cause small, itchy blisters on the edges of the fingers, toes, palms, and soles of the feet. It can be triggered by stress, allergies, or exposure to certain substances.

    • Treatment may include topical steroids to reduce inflammation and itching. Keeping the skin moisturized and avoiding irritants can also help.

  • Contact Dermatitis: This is a skin reaction resulting from exposure to allergens or irritants. It can cause redness, itching, and blisters.

    • Identifying and avoiding the irritant or allergen is key. Topical treatments can help manage symptoms.

What you can do

  1. Foot Hygiene: Keep your feet clean and dry. Change socks regularly, especially if they become damp. Consider using moisture-wicking socks to help keep your feet dry.

  2. Footwear: Rotate your shoes to allow them to dry out between uses. Consider wearing open-toed shoes or sandals when possible to allow your feet to breathe.

  3. Antifungal Treatment: Continue using antifungal creams as directed. If over-the-counter options aren't effective, consult a healthcare provider for prescription-strength treatments.

  4. Moisturize: Use a gentle, fragrance-free moisturizer on your feet to help with dryness and calloused skin.

  5. Symptom Tracking: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider. This can help in identifying patterns or triggers.

What you should look out for

  • Worsening Symptoms: If your symptoms worsen or don't improve with treatment, it's important to consult a healthcare provider.

  • Signs of Infection: Look out for increased redness, swelling, warmth, or pus, which could indicate a bacterial infection requiring medical attention.

  • Persistent Pain: If the sharp pain in your foot continues or becomes more severe, seek medical advice to rule out other potential causes.

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare professional for a formal diagnosis and treatment plan.

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14 d ago

People Also Ask

What are the common symptoms of athlete's foot?

Common symptoms of athlete's foot include itching, burning, cracked, and peeling skin, especially between the toes. Blisters that may ooze and a persistent odor are also typical signs.

How can dyshidrotic eczema be managed effectively?

Dyshidrotic eczema can be managed by using topical steroids to reduce inflammation and itching, keeping the skin moisturized, and avoiding known irritants. Stress management and identifying triggers can also help.

What steps can be taken to prevent contact dermatitis on the feet?

To prevent contact dermatitis, identify and avoid allergens or irritants. Wearing protective footwear, using hypoallergenic products, and maintaining good foot hygiene can reduce the risk.

When should I see a doctor for foot pain and skin issues?

You should see a doctor if your foot pain persists or worsens, if you notice signs of infection like increased redness or pus, or if over-the-counter treatments are not effective in managing your symptoms.

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