Dermatoses of the Foot
William L. Weston MD, FAAP1
1 Professor and Chairman, Department of Dermatology; University of Colorado School of Medicine, 4200 East Ninth Ave, Denver, CO 80262
Diagnosis of skin conditions restricted to certain body regions may be difficult. Those of the foot may present a considerable problem to the practicing pediatrician, as indicated by a study that demonstrated that although athlete's foot, or tinea pedis, was frequently diagnosed by pediatric residents, it could not be confirmed by direct microscopic examination of skin scales or by fungal culture in any of the patients who had this disease diagnosed. Pediatricians may suspect that prepubertal children have athlete's foot, but its occurrence is actually uncommon; the prevalence is 35 times greater among adolescents. Thus, skin conditions other than athlete's foot are far more likely to be the cause of a dermatosis of the foot in the prepubertal child. The precise incidence of each of the specific ones affecting the foot is not known, but the most common conditions may be inferred from the overall vital and health statistics for US children in general, and from the experience derived from ambulatory pediatric settings. The purpose of this review is to provide an update for the practicing pediatrician on the clinical features, differential diagnosis, and current treatment of the seven most common skin conditions affecting the feet of US children. A problem-oriented algorithm is included to provide a simplified approach to the dermatoses of the foot in childhood.
