54 yrold female came with complaints of itching over the foot.skin has been peeled off from itchy sites.

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Contact dermatitis

From the picture it seems to be either Nummular eczema or Tinea infestation I.e. ringworm. From details history of her work type & habits and exposure to irritants etc. & thorough and minute inspection may help you to confirm the diagnosis. If diagnosis is not possible clinically go for microscopy of scrappings' KOH preparation--if fungus with hyphae is present to confirm ringworm. If comes out to be ringworm ---oral and topical antifungal, antihistaminic for relief of itching etc. If it diagnosed as Contact dermatitis --avoid causative irritant substance, corticosteroid topical application and keep the area moist. May need symptomatic treatment with antihistaminic.

Contact dermatitis .from her walking shoes Her rt. toe nails showing fungal infection

Primary contact Dermatitis.. culprit. Lace knot

Acute contact dermatitis

Allergy to footwear , eczematous dermatitis

ACD Mild steroid cream locally. Wash area with diluted betadine lotion locally and than calamine lotion locally. Sulphur 2% oint biweekly locally.

@Dr. Prag Kalra -contact dermatitis

Should r/o diabetes mellitus. Remove causative factor, take full course of low dose steroid cream, antipruritics , watch for recoverg

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