By Gary M. White, MD
Weber-Cockayne Variant of Epidermolysis Bullosa Simplex
Plantar Warts, Mosaic
Porokeratosis Palmaris Plantaris Et Disseminata. Multiple circular lesions with a hyperkeratotic rim on the palms, soles, and body are characteristic.
Cutaneous Larva Migrans
Regressing Plantar Wart
Recurrent Palmoplantar Hidradenitis In Children.
Mycobacterium Abscessus Infection.
Basal Cell Nevus Syndrome
Acral Erythema Of Chemotherapy
Graft vs. Host disease
Gloves And Socks Syndrome
Parechovirus . This virus causes a unique maculopapular rash with solid erythema of the soles [Pediatr Dermatol. 2014 Mar-Apr;31(2):258-9].
The two main considerations for one or two red, scaly feet are [tinea pedistinea_pedis.html) and eczema. A KOH is usually the easiest way to distinguish the two. Clues that tinea is the cause include i) coexistent onychomycosis, ii) a moccasin distribution (redness and scale along the entire sole and extending up a cm. on to the sides), and iii) involvement of the web spaces. Clues that eczema is the cause are i) failure to improve on a topical antifungal medication and/or ii) involvement of only the instep.
Rarely, an allergic contact dermatitis to an allergen in shoe wear (shoe dermatitis) may be the cause. In this case, topical antifungals are ineffective and topical steroids help but do not clear. Often, the dorsa of the feet are involved. Patch testing is needed to establish this diagnosis.
Tinea Pedis. This case was unusual in that only the instep was involved, suggesting eczema. But KOH and culture proved it to be fungal.
Eczema of the Soles. In comparison, this patient had unilateral eczema.
Secondary Syphilis. Courtesy Stephen Goldberg, MD
Psoriasis. Sometimes, psoriasis can be relatively thin, mimicking eczema.
Juvenile Plantar Dermatosis
Pityriasis Rubra Pilaris
Diabetic Foot Ulcer
Squamous Cell Carcinoma or Basal Cell Carcinoma
Wart, see above.
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