Need help with dermatology problem

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Hi All

I have a dermatology problem that I haven't seen before and have no idea of what it is or its cause.

The patient is a 56 year old female of Asian heritage. She was diagnosed with cancer 18 months ago and subsequently underwent chemotherapy and radiation treatment. The cancer is in remission.

Two months after her last treatment she developed a full body rash about which I know little. The doctors did not determine its cause but it settled after about 1 month - it was not itchy.

One month after that the patient developed a rough patch on the bottom of her left heel and lateral plantar edge of left foot. It became very tender to walk on and felt like lots of little stones under the skin.

After 5 months her GP referred her to a dermatologist her told her she had an allergy of some sort and gave her a jar of 10% salicylic acid to apply daily which she has been doing for 4 months with no improvement in symptoms.

It's hard to describe and the patient didn't want a photo taken but in appearance it looks sort of like a lot of little corns with an overlying layer of callus. I debrided the entire area which was quite uncomfortable for the patient (whereas callus and corns wouldn't be) and enucleiated all the "corns". This resulted in an area with lots of little craters but is still very uncomfortable to walk on (no immediate reduction is discomfort). I have applied a liberal layer of natural moisturising cream and two layers of Fleecy Web which does provide some level of comfort. I have suggested she soak her feet in salty water daily and I will be reviewing her in two weeks time.

There is no other hard skin on either foot or elsewhere on her body.

Does anyone have any suggestions?


RStone

 

Can you post a picture?

 

Unfortunately not Craig as the patient would not permit me to take a photo - sorry.

RStone