Random Severe Burny Lesion

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Hello World.

I had an interesting case today.

A 15 year old slightly overweight, physically active red head caucasion male with Ligamentous laxity, Pes Planus Genu Valgum and recuravtum and a host of associated "Biomechanical Symtoms.........."

He presented (with his Mum) with concerns over sporadic & random severely painful burny, itchy (Not Bullous or vesicular) lesions on the Plantar mid area of both feet. I am only taking the Pts Mums word for its description, as it comes and goes with about 1-2 weeks shows, appaently it settles and doesnt leave and dry or scabby skin?

He has been to the GP several times over the last 2-3 years with this and they have tried everything from Cortisones, Shingles Rx's to Antifungals, antibacterials etc. The Gp is at her wits end, Although she hasn't referred to a dematologist yet (which I suggested).

The boy has concurrent interdigital and dorsal distal tinea with is being treated with lamisil and other topicals with good effect.

The Patient has been seeing a Chiropractor off and on for several years after a Lumbar spine injury (Approx L3L4).

Q: If this isnt some kind of cellulitis localised? or a dematitis of some kind , or shingles etc , are there any chance of a Lumbar lesion causing these mysterious lesions on the soles? Sciatica and Secondary sensitisation, can effect the vascular and sensation of an area.

Or should I just reinforce the Dermatoloist with his GP?

P.S I have issued Off shelf insole with Rearfoot wedging and met domes to help his Biomech problems and reduce any Mortons Neuritis , and I am thinking, if he has an allergy to rubber and / or heat these should bring on his symptoms.

Sorry about the long post but It would be good to get some more info about this , as the Poor chap misses alot of school and is often in tears with the pain.



Cheers

Joe Wheeler:drinks

 

Hi Joe,

You may already have asked pts. mum this but, ask her to photograph the area when it is problematic.

It may indicate something easier to identify than her description.

Just a thought.

Regards,

 

Good Idea

Neva fort of vat !



Cheers