Inflammatory |
Allergic contact dermatitis | Common F > M Age: any age | Pruritus and painful fissures Onset: hours to days after contact with allergen | Acute: Papules and vesicles on an erythematous base (Figures 8-4 and 8-5) Chronic: xerosis, fissuring, hyperpigmentation, and lichenification (Figures 8-1, 8-2, 8-3) |
Atopic dermatitis | Common M ≥ F Age: usually begins in childhood but may persist | Pruritic and painful Chronic waxing and waning course Family history of atopy | Presents with swelling, xerosis, fissuring, erythema, and lichenification on the dorsal feet and soles (Figure 2-10) |
Dyshidrotic dermatitis | Common F ≥ M Age: usually young adults | Severely pruritic or painful. Chronic and recurrent with episodes lasting 2-3 weeks | Multiple grouped vesicles and erosions on a noninflammatory base located on the soles (Figure 8-12) |
Psoriasis vulgaris | Common M = F Age of onset: any age, but peaks in 20s and 50s | Pruritic and painful Chronic, indolent course. Associated with arthritis and nail pitting/dystrophy Family history of psoriasis | Well-demarcated plaques with adherent, thick scale on an erythematous base. Less commonly present with pustules over pressure-bearing regions of the soles (Figure 9-1) |
Palmoplantar pustulosis | Uncommon F > M Age: 50-60 years of age | Pruritus, burning or pain Chronic waxing and waning course | Scattered creamy-yellow pustules and dusky-red macules on soles, with a tendency to affect the heel and instep of the foot; may be bilateral or unilateral |
Infectious |
Tinea pedis | Common M > F Age: post-puberty | Asymptomatic or pruritic Lasts months to years Associated with onychomycosis | Interdigital type: dry scaling and/or maceration, peeling, and fissuring in toe webs (Figure 10-9) Moccasin type: well-demarcated erythematous patch with fine, white uniform scale on soles and sides of feet (Figure 10-10) Inflammatory/bullous type: vesicles or bullae containing clear fluid, erosions on the soles (Figure 10-11) |
Cellulitis | Common M = F Age: any age, but occurs more commonly on the feet in adults | Pain swelling, fever, malaise, and chills Increased risk in diabetic patients and patients with fissures on their feet | Localized erythema, warmth, swelling, and tenderness with ill-defined borders (Figure 12-3) |
Warts | Common M > F Age: more common in children and young adults | Asymptomatic or painful. May persist for years | Discrete or confluent hyperkeratotic papules or plaques on soles. May have black or brown dots within the lesions created by thrombosed capillaries (Figure 11-7) |