Dermatological Query Heel Lumps?
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Dear All,
Trust these images get through as I am a little stumped with what these are.
This patient first presented with a sore hard spot on her heel (see attachment listed as jpg) following the Hx and assessment I felt it was a wart. My Rx involved education on what is a wart and options for Rx the patient liked the sound of duct tape and bannana therapy (which has worked for me before) she then went off for a month. Medical Hx unremarkable GHG no previous wart or dermatological issues before. Although husband had something on his heel and another podiatrist burnt it off, although she was not sure if it is the same thing on her foot.
She has recently return with more discomfort in the heel - swelling and redness. I decided to debribed the area to discover 4 circular lesions which have the appearance of a subdermal blister. I attempted to denucleate to see if there was a foreign object in the site and or fluid, neither of which I found, the bleeding occured as I went into her dermis layer. I asked her GP to do a biopsy but he did not want to instead he has prescribed a topical corticosteriod and asked her to return in 1 month if still a problem.
DDx welcomed - lipomas, fat pad rupture etc
Rx options also welcomed.
Regards
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