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Had an 11 year old boy yesterday. He presented with heavy heavy callous on both 1st MPJ's (plus large fissure), 1st IPJ's, both heels, HD's both 5th MPJ's, pinch callous on lesser toes, some ID blisters. Has had this problem "for his whole life" as he said. Plays hockey a lot in the winter. In the summer he plays various different sports.
Has virtually no problem with the feet during the summer months, callous almost disappears. But in winter it is a chronic problem. His feet are quite hyperhidrotic, mal odorous. Not much pain while I was reducing the lesions but cannot walk barefoot at home and wears runners all the time to provide more cushioning. Obviously wearing the socks and shoes all the time is contributing to the odour and sweaty feet but he cannot go without.
His feet are still quite hypermobile, genu valgum, medially deviated STJ axis but not pes planus. He didnt write down his weight on the new patient form but I'm guessing he's about 140 pounds, about 5' 4". Very pleasant boy, didnt seem anxious although his Mam was very anxious to solve the problem obviously. He says it doesn't stop him playing hockey, he just gets on with it.
He has been to see a dermatologist and other podiatrists. All of them say it is due to friction and abnormal foot motion and it certainly looks that way. He looks like he's been running a few marathons recently. I couldn't take any pictures but I hope to see him again in the next few weeks so I will try to take some then.
I hope to get him into functional orthoses as he has never had them before. It would definitely help. I recommended some exfolliant lotions to see if it makes a difference. I think this is unusual in a child his age and just wondering if there's something else going on. He doesnt have any other medical issues. No lesions anywhere else on the body and no family history of dermatological problems......Anyone ever seen something like that before?
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