Skin Diseases of the Feet




INTRODUCTION TO CHAPTER



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The plantar surface of the foot has the thickest keratin layer, a high concentration of eccrine sweat glands, as well as sensory nerves, including Pacinian corpuscles, and other mechanoreceptors. The combination of abundant keratin and sweat creates an ideal environment for fungal infections. Friction and contact with footwear also make the feet susceptible to contact dermatitis. In addition, the feet are disproportionally affected by vascular disorders, due to their gravity-dependent anatomical location, and by peripheral small fiber sensory neuropathies. Since the feet are a site of frequent injury, vascular disorders and sensory neuropathies predispose this area to recurrent and difficult-to-manage wounds.




APPROACH TO DIAGNOSIS



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The most common causes of skin diseases on the feet are dermatophyte infections and inflammatory dermatoses (see Table 36-1). Clinically these two categories of disease are often indistinguishable from one another. The presence of fissures and/or scale in the toe web space and nail dystrophy is more suggestive of a dermatophyte infection, but nail dystrophy can also occur in psoriasis.




Table 36-1.Differential diagnosis for diseases of the feet.
Jan 15, 2019 | Posted by in Dermatology | Comments Off on Skin Diseases of the Feet
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