Hi,
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I had a 50 year old lady attend the clinic recently with an interesting dermal condition:
Arch of right foot only, started after having been in SE asia about 1 year ago, but wearing thongs predominantly. Has never had this before.
Symptoms - itchy and annoying so much that felt need for constant scratching - consequently making lesion worse.
Has visited GP several times who has suggested numerous treatments
Over counter anti-fungals useless.
Tinasil 250mg oral terbinafine has not improved it. Experienced spots over body (a known side effects) so stopped.
Doctor then recommended Eulactol Gold (!!!) whilst using resolve powder- and this was made dramatically worse.
Now using Elocon .1% helps settle itchiness, and only mild effect on lesion size
Further information I gathered was:
Compliance with medicaments was excellent, footwear choices poor (still barefoot in high heeled shoes) and on feet for long periods. Would not normally suffer sweaty feet.
No known medical conditions aside from elevated blood pressure, no "unwell symptoms" experienced when overseas and lesion was caused. Appears to get worse in warmer conditions.
This looks to me almost like a really severe version of Pitted Keratolysis crossed with some sort of dermatophyte. I might be beyond my depth here, so said I'd check here, and likely refer onwards.
If anyone can help me out on what they think it is, I'd greatly appreciate it. THanks. :)
PS: the pics, this lady has approximately a Size 6 ladies foot size, but I guess the scale is not overly important in this case?
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