A long time patient of mine returned to my practice complaining of red creases on her lesser toes (see attached photo). She had sought the care of a dermatologist prior to consulting who prescribed various cream which were no help. The creases are mildly uncomfortable and have only been present about 1 1/2 years.
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My patient has structural hallux limits. I have her wearing a rocker sole shoe with a functional foot orthotic that has a rear foot post and 4 degree medial skive, a reverse Morton's 2-5, and a 1st ray cut out since she has sesamoiditis. Presently she has no 1st MPT pain when ambulating only the mild less toe pain, which has improved slightly since she she started wearing the new orthotics and rocker shoe.
Any ideas on how to manage what I think DIPJ irritation from excess flexor stabilization?
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