When A Patient Presents With Symmetrical Lesions On The Toes

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Answering The Key Diagnostic Questions

1. Has the patient received a patch test?
2. Contact dermatitis
3. Atopic eczema, Raynaud’s disease and pitted keratolysis
4. The rash is symmetrical.
5. Avoiding shoes with allergens, wet dressings, systemic steroids, topical steroids and/or use of coal tar and emollients

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By M. Joel Morse, DPM

Dr. Morse is the President of the American Society of Podiatric Dermatology. He is a Fellow of the American College of Foot and Ankle Surgery, and the American College of Foot Ankle Orthopedics and Medicine. Dr. Morse is board certified in foot surgery.



1. Barone EJ, Jones JC, Schaffer JE. Skin Disorders. Lippincott Williams and Wilkens. Philadephia. 2000
2. Storrs FJ. Foot Dermatitis at http://www.acderm.com/FOOTDERMATITIS.pdf
3. Adams AK, Warshaw EM. Allergic contact dermatitis from mercapto compounds. Dermatitis 2006;17(2):56-70.
4. Pariser DM, Caserio RJ, Eaglstein WH. Techniques for Diagnosing Skin and Hair Disease. Second Edition. Thieme Inc. 1986
5. Blair K. Latex Substitute As an Allergen. Dermatology Times of Canada. January 2004.

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