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Hi All,
I have a patient with a skin condition I haven't seen before.
He is a 45yo type1 diabetic with a VERY high arch -supinated foot.
I am seeing him for orthotic therapy BUT he also has a skin condition which although causes no symptoms he is very concerned about this because it's "new and weird".

It looks like sock ridges under the ball (MPJ 1-5) of the foot. The ridges are about 2mm wide in size, palpable, fairly evenly spaced and longitudinal on the plantar metatarsal area of the foot. They are on both feet but the left foot (which has the higher arch) is much worse then the right foot. No change to neurological or vascular status of the foot.

He noticed the lesions over 3 months ago. They are there all the time - even when he wakes up in the morning before getting out of bed.
I have checked out shoes and socks and can find nothing that could be causing this problem.

Does anyone have any ideas what this might be ?..
Thanks
SRD

 

Hi there

I have no idea what the skin condition is...

BUT, a "VERY high arch" foot in someone with longstanding diabetes is motor neuropathy until proven otherwise (eg idiopathic, congential or other form of cavo-varus deformity). It is the wasting of intrinsics that gives this appearance.

LL