All,
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This summer I have had 3 or 4 patients who whilst in for musculoskeletal complaints mentioned in passing during subjective history taking that they were slightly bothered by the aesthetic appearance of their feet, particularly whilst in flip flops.
Usually evident with this scenario has been some skin change (?depigmentation) over the dorsum of the PIPJs/DIPJs, and often no hyperkeratosis noted. I have always just attributed this to chronic low level toe box trauma whilst shod, and informed that it is unlikely to significantly improve, but appropriate footwear could prevent it from deteriorating (visually) further.
However since the last lady I broke this news to burst into uncontrollable tears, I wondered if maybe I should find out if there is anything anyone else says/recommends in these situations?
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