Hi , I saw a patient yesterday who has been suffering from chronic blisters on both heels (Right then Left )for more than 6 months now .
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This is a lady who is large and has a number of eczema type skin issues . which have been causing her problems for a bout 3 years.
She has skin plaques on the tips of both second toes under the nail these are shiny and planar , to me they look psoriatic. she has had fingernail problems and toe nail dystrophy.
She has had test for fungal infections done by a couple of dermatologists and all results have been negative .
The blisters on her heels are biomechanical in nature at least partly , as there seems to be a plaque of callus in the centre of the blister which is the initial cause .
but this does not explain the size and type of blister and the time it takes to heal.
My thoughts are auto immune or Psoriasis , as underlying conditions .
thoughts and ideas would be greatly appreciated on to what could be the underlying cause.
Initially I am only treating the blisters but would like to get an idea of what is going on ....
the Dermatologists she has seen were more involved in cosmetic treatments .....
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