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Questions for Dr. Kennedy
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Husband's feet
Posted by: Jean
Date: October 28, 2000 8:45 PM

My husband is 37 yrs. old and healthy, except for a rash on the top of his feet with which he has suffered for the past 12 years. It never completely goes away. It starts as a patch of little red bumps, then waters off and scales over. He has been to numerous medical doctors. They say it is contact dermatitis. He does exactly what they prescribe and it never completely goes away. It is very itchy. It seems to get worse when he eats foods with a high sugar content, or high carb diet. I have done research using Mosby's Medical Encyclopedia and identified it as Dermatitis Herpetiformis (?). I was employed for 5 years as a medical assistant for a pediatrician/allergist and saw many types of rashes. I know this may sound weird but the only other rash I have seen that resembles the symptoms as his is when I have had a yeast infection rash. I have also read about the Yeast Syndrome and realize that this can also produce different types of rashes. Can you help to identify this problem? I am concerned that it could be serious, since it never completely goes away, and it has left severe scars (dark spots) underneath the lesions. I am convinced that we are not dealing with contact dermatitis. He also has swelling in his feet when the rash is at a peak time. He had a biopsy done just this week. The pathology report diagnosis = "Hyperkeratosis, Perivascular Dermal Edema" (Dr.'s comment = "The findings are those of a benign process and could represent a benign keratosis. The possibility of stasis changes also exists. given the perivascular edema.")

RE: Husband's feet
Posted by: Ron Kennedy, MD
Date: October 31, 2000 4:02 AM

If this is a contact dermatitis, the origin comes from within. The probability is that your husband's lifestyle has made him a culture tube for yeast and fungus. A trial of topical antifungal cream would be a safe way of diagnosing the problem. If this is "athlete's foot" a topical such as Lamisil will suppress it for a time. Even if this suppresses the problem, the root cause would remain. This could be dietary or more serious such as a gut wall infection. To get to the bottom of this you need a doc who is versed in such things. Unfortunately, they are hard to find.



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