Dermatology Diagnosis »
When A Patient Presents With Thick, Yellow Toenails And A Rash On Both Feet
An 80-year-old Caucasian presents to the office complaining of thick, yellow, unsightly and sometimes painful toenails. The patient, a retired RN, has had a history of a rash affecting both feet. The rash is sometimes pruritic and sometimes not. She has tried applying topical antifungals to her toenails without success. However, antifungal creams have sometimes helped her skin condition.
Dermatology Diagnosis »
Treating A Patient With Bilateral Rashes And Intense Itching On The Top Of The Feet
A 53-year-old male presented to the office with the chief complaint of a rash on the top of both feet, worse on the right than the left. The duration of symptoms had been more than six months. He related intense itching that required scratching. His wife told me that he would wake her up due to rubbing his feet in bed. His primary care physician prescribed a course of a topical cortisone cream using triamcinolone 0.1%, which helped minimally.
Dermatology Diagnosis »
Diagnosing And Treating A Longstanding Heel Lesion
You walk into the room to see a well-dressed 48-year-old businesswoman sitting in the treatment room. She has her right foot cradled in her hands and is massaging the heel. You notice the stylish high heels on the floor beside her.
Dermatology Diagnosis »
When A Patient Presents With A Pruritic Lower Extremity Rash
A 50-year-old female presented to the office with the chief complaint of an itching rash on her ankles and feet. She reported the itch to be severe at times. The duration of symptoms was for at least a few months.
Dermatology Diagnosis »
Treating A Patient With Annular Lesions On The Lower Extremities
A 26-year-old male presented with salmon colored annular lesions extending from the dorsum of his feet proximal into his lower extremities bilaterally. He originally thought he had eczema.
The patient had no pertinent past medical history or allergies, and no current medications. The patient had not traveled recently and had no recent history of infection. The lesions were mildly pruritic and he had not changed any of his detergents, soaps or anything else in his environment. He did not relate this rash as appearing after any excessive sun exposure recently. He denied fever, chills and joint pain.
Dermatology Diagnosis »
When A Runner Presents With Painful Plantar Lesions
A 44-year-old competitive runner presented with a history of painful lesions on the plantar aspect of both feet. He stated that the problem initially began with the presence of a single lesion. He denied any history of trauma to the area and indicated that there has never been any bleeding from the site. Further lesions developed and they started to cause some discomfort while he was running.
Dermatology Diagnosis »
When A Patient Presents With Itchy Red Plaques In The Lower Extremities
A 25-year-old male who thought he had tinea pedis and corporis presented with red plaques extending from the medial aspect of his feet proximal into his lower extremities bilaterally. The patient had no pertinent past medical history, no medications and no history of dental work. The lesions were pruritic and he noticed when his cat scratched him, small marks remained on his legs that were also itchy. Due to this, he believed the skin disease was spreading and contagious.
Dermatology Diagnosis »
When A Patient Presents With A Skin Growth On The Heel
A 51-year-old male presented to the office with the chief complaint of a skin growth on his right medial heel. He related that the mass has grown slowly over the prior year. He did not have any severe pain with it other than shoe irritation. The skin lesion would bleed easily with any pressure on it.
Dermatology Diagnosis »
When A Patient Has A Discolored Onychomycotic Toenail
While research has shown that onychomycosis is more common in patients with diabetes, we need to be cognizant of different etiologies and perhaps reexamine those when an initial treatment course fails to get results.1
A 36-year-old woman presented with a six-month history of a discolored toenail of the right great toe.
She was a moderately overweight Caucasian woman with a 20-year history of juvenile-onset diabetes mellitus. She had poor to moderate control of her disease.
Dermatology Diagnosis »
When A Patient Presents With A Painful Red Toe
As winter approaches, patients must be aware of the punishing effects of cold on the lower extremity. Given that patients with feet affected by the falling temperatures may present more commonly to podiatric offices, a correct diagnosis and treatment are vital.
