Skin Disorders Affecting the Soles of the Feet

Question 1

Secondary to the human papilloma virus
Firm, hyperkeratotic lesions
Pinpoint petechiae centrally within the lesions
May coalesce with surrounding warts to form mosaic warts

Answer 1

Verrucas

Question 2

More commonly called Athlete’s foot
Affected skin is moist, flaky and itchy

Answer 2

Tinea Pedis

Question 3

What are these and how do you treat them?

Answer 3

A corn is small areas of very thick skin secondary to a reactive hyperkeratosis
A callus is larger, broader and has a less well defined edge than a corn

Callus = keratolytics (salicylic acid, 10% urea cream)

Corns = Footwear, Keratolytics, Cushioning (e.g. corn pads). Occasional surgery.

Question 4

May be acquired or congenital
Describes a thickening of the skin of the palms and soles

Answer 4

Keratoderma

Question 5

What is an aquired cause of keratoderma?

Answer 5

Reactive arthritis

It is called keratoderma blennorrhagica.

Question 6

What is this?

Answer 6

Pitted keratolysis

Affects people who sweat excessively
Patients may complain of damp and excessively smelly feet
Usually caused by Corynebacterium
Heel and forefoot may become white with clusters of punched-out pits

Treatment = keep foot dry.

Question 7

What is this?

Answer 7

Palmoplantar pustulosis

Crops of sterile pustules affecting the palms and soles
The skin is thickened, red. Scaly and may crack
More common in smokers - nicotine receptors in sweat glands are activated and cause an inflammatory process.

Can be associated with coeliac disease, thyroid or T1DM aswell.

Test for autoimmune disease. Treatment = stop smoking, try & avoid gluten, avoid friction, apply emollients liberally.

Question 8

Affects children. More common in atopic patients with a history of eczema
Soles become shiny and hard. Cracks may develop causing pain
Worse during the summer

Answer 8

Juvenile plantar dermatosis