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Seeking Guidance for Persistent Rash on My Foot

6/15/2025, 12:10:20 PMMale25-34

I am a 26-year-old female and have been dealing with a rash located on the top of my foot for nearly two months. Given my lifelong experience with eczema, I didn’t initially react with alarm to this new irritation on my foot. The rash extends slightly between my toes, which is a new development for me. When I mentioned this to a friend, she suggested it might be athlete’s foot. In response, I decided to use ketoconazole shampoo that had previously been prescribed for a different issue. However, there was no noticeable improvement in the rash. While it occasionally itched, the discomfort was not severe. In an effort to address the situation, I also began applying an over-the-counter terbinafine cream, thinking the shampoo might not be sufficient. Unfortunately, this too failed to yield any results. As the rash progressed, I started to observe pustules forming, which raised my concern about a possible infection. This prompted me to visit a walk-in clinic, which turned out to be quite a frustrating experience. There, I received a prescription for oral fluconazole along with a prednisone injection. This occurred about a month after the rash first appeared. Although I’m not entirely sure what contributed more to the improvement at that stage, I noticed some positive changes initially; however, the rash returned soon after. In my search for a more definitive solution, I consulted a dermatologist who prescribed ketoconazole cream and mupirocin ointment, advising me to use both treatments for a two-week regimen. After completing the first week, I have yet to see any improvement, and I’m beginning to worry that this might be indicative of a more serious condition. I’m now contemplating whether consulting a podiatrist could be a more appropriate next step. Any advice or suggestions would be greatly appreciated!

FibromyalgiaRheumatologyChronic Pain

Answers (1)

Cony

6/15/2025, 12:10:36 PM

OpenHealth AI

It sounds like you’re dealing with a persistent and frustrating rash on your foot that hasn’t responded well to various treatments. Given your history with eczema and the new symptoms like pustules, it's important to consider a few possibilities while remaining focused on finding relief.

Explanation

The rash could be due to several factors, including:

  • Eczema Flare: It's possible that the stress of a new location, such as your foot, has triggered eczema.
  • Fungal Infection: Your friend suggested athlete’s foot, which is a common fungal infection, and it can sometimes cause pustules.
  • Bacterial Infection: The development of pustules might indicate a secondary infection, especially if the skin barrier is compromised.
  • Other Dermatitis: Conditions such as contact dermatitis or psoriasis may also manifest as rashes.

Since you have already tried several treatments targeted at both fungal and bacterial issues without sustained improvement, it's understandable that you're feeling concerned.

Next Steps

  1. Continue with Treatments: Follow the dermatologist’s prescribed regimen of ketoconazole cream and mupirocin ointment for the full two weeks. Make sure to apply them as directed and avoid mixing other treatments during this time, as changing regimens could disrupt healing.

  2. Monitor Symptoms: Keep a diary of your symptoms, noting any changes in the rash, itching, and whether there are triggers that worsen it. This information can help you and your healthcare providers identify patterns.

  3. Review Foot Care:

    • Moisturize: If eczema is a concern, ensure you're properly moisturizing your foot—consider a thick, fragrance-free emollient after washing.
    • Keep Dry: Make sure to keep your feet dry, especially between the toes, to discourage fungal growth.
  4. Consider a Podiatrist: If there is no improvement after two weeks or if symptoms worsen, seeing a podiatrist could be beneficial. They can provide targeted examination and treatment options since they specialize in foot issues.

  5. Follow-Up with Dermatologist: If you don’t see improvement at the end of the treatment regimen, returning to the dermatologist for further evaluation may be necessary. They might explore alternative diagnoses or additional testing if needed.

  6. Avoid Self-Medicating: Avoid using new over-the-counter products without consulting your dermatologist or podiatrist to prevent irritation and confusion in your treatment plan.

Reassurance

It’s completely reasonable to feel concerned given the duration and persistence of the rash, especially with the changes you've observed. It's clear that you are actively seeking solutions, and hopefully, the combination of sticking with your dermatologist's prescribed treatments, carefully monitoring your symptoms, and considering further specialist input will lead you toward better skin health. Stay proactive, and don't hesitate to reach out for further help when needed!

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