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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
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