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.
... Read More.
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... Read More.
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.
“You cannot imagine the pain that I feel, doctor,” she says before you even ask a question. “It feels as though I have a little dagger pressing... Read More.
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.
The patient had no prior treatment for the condition. She denied any known cause for it. She denied any new medications, activities, recent traveling or new... Read More.
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... Read More.
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.... Read More.
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... Read More.
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.
He denied any injury or punctures to the skin. His past... Read More.
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... Read More.
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.
Three patients presented with a single red, swollen, painful toe. I saw all patients individually... Read More.
An 85-year-old Caucasian male presents with a heel ulcer after spending eight weeks in a rehabiltation home following hip replacement surgery. He presently spends much of his time in a lounge chair or in a wheelchair. He has a history of angina, arthritis, aortic valve replacement, prostate cancer with radiation treatment and Parkinson’s disease. He is taking carbidopa-levodopa... Read More.
Key Questions To Consider
1. What essential question does one still need to help make the diagnosis?
2. What is the tentative diagnosis?
3. Can you list at least three differential diagnoses?
4. What features in this condition differentiate it from other conditions?
5. What is the suitable treatment of this... Read More.