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Dermatology and Feet

Dermatology and Feet

One of the many facets of podiatry is dermatology and if you think about it, feet are covered in skin and nails are just an adaption of skin.

There is now a podiatric speciality known as Podiatric dermatology which has grown out of the fact, that as a podiatrist much of what you do crosses over into dermatology and therefore many podiatrists want to know even more and specialise in this area.

When I go to conferences dermatology lectures are always packed. Many of the routine treatments I am involved in are dermatological in nature, Hyperkeratosis (callous), Heloma durum (corns), Human papiloma virus (verrucas) Onycomycosis (nail fungus) are all dermatological complaints which podiatrists treat every day. There are also the more serious skin conditions that often present in clinic.

Skin cancer is very common in feet as after to hands and faces feet are exposed to the sun probably more than any part of the body. From solar Keratosis sometimes known as sun spots, Squamous cell carcinoma, Basal cell carcinoma and even malignant Melanoma are all commonly seen on feet.

I think I have mentioned before that one of the differential diagnosis for ingrown toenails particularly if they are persistent, is malignant Melanoma. Obviously with skin cancers it is not a podiatrist’s role to treat them and swift referral especially in the case of suspected Melanoma to a Dermatologist is essential.

But malignancy aside, there are still many skin conditions of the feet that podiatrists treat very well. Cracked heels are very treatable with debridement and advice on the correct emollients. Often cracked or split heels are a symptom of psoriasis and psoriasis has other manifestations in the feet one of which is psoriatic nails. These often look just like fungal nails and although the psoriasis in nails cannot be eliminated it can be managed very well by reducing the nail bulk and improving appearance.

Athlete’s foot which is really a fungal infection is a very common presentation in clinic in its many forms. Even bacterial infections like Pitted Keratolysis where white holes are seen in the bottom of the feet especially when wet are very treatable in clinic.

There are too many skin conditions seen in feet to mention them all, but the above are a few which are commonly seen.