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Help with diagnosis of plantar skin condition

Discussion in 'General Issues and Discussion Forum' started by amw504, Apr 23, 2010.

  1. amw504

    amw504 Member


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    Hi everyone.

    I hope you can help me with a diagnosis. I haven’t been qualified very long and I’m worried that I may be missing something obvious, or may miss something serious.
    :wacko:
    My patient (Lady in her 40s) is concerned about an area on the plantar aspect 3/4th metatarsophalangeal joint area left foot which appears to be increasing in size. O/E the area is oval, 1cm high and 6mm across, very slightly raised. There is no hard callus over it, but there is some soft thickened skin there. Through the skin I can see 5 distinct pinhead sized white dots. Since the dermal striae are uninterrupted over this, I presumed they were seed corns and would ‘pop out’ during debridement. This didn’t happen, and the white areas just continue straight down like tubes. There was no bleeding even though I debrided quite a lot. The patient says that the area is not painful, but I squeezed the lesion as though testing a verruca and she did feel a sharp pain. Can a verruca present like this? I would be very grateful for some advice.
    Thanks
     
  2. DTT

    DTT Well-Known Member

    Re: Help with diagnosis please

    Hello
    Any chance of a photo ??

    If your really not sure, to refer on in the sensible thing to do but if you want an opinion, you have a very capable "dermy" pod in Winchester (Bel) who I'm sure would oblige.
    Hope that helps
    Cheers
    Derek;)
     
  3. Mr C.W.Kerans

    Mr C.W.Kerans Active Member

    Dear amw504,
    Skins are frequently difficult. Best to refer for a specialist opinion to know what it is you are dealing with. I'd like to know what this condition turns out to be when you find out. Good luck.
     
  4. pod at home

    pod at home Active Member

    Hi amw504;
    i agree with Mr CW Kerans - if in doubt refer on! but i find this website (which you've probably seen already) really helpful http://www.dermnetnz.org/ and the images are really useful!
    Another tip - (againyou probably know) take photos at each visit and accurate measurements and if its evolving definitely refer on to a specialist dermatologist.
    Good luck - and if you find out what it was - let us know x
     
  5. Zuse

    Zuse Active Member

    Hi
    i agree with Mr CW Kerans too allways refer if you dont know or are unsure.
    you could all ways ask some one more senior than your self two! i havent been qualified for very long and if i am unsure about any thing then i ask, even if it turns out to be nothing.
    its better to be safe than sorry!
    good luck
     
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