Contact derm. of the soles

The pressure points of my feet (soles and sides, mostly) have been beet red, cracked and itchy for 1-1/2 yrs. As a result of patch testing and a biospy, I was told I have basically a metal allergy: chromate, nickel, gold, cobalt, plus neomycin, sun tan lotions, fragrances. The puzzling part is that the chromate in shoes is the upper part, whereas my problem is the soles. I also considered perhaps the fact that the debriding device I use that contains aluminum oxide crytals on the tip might be the culprit; but I have not used it for 2 months and my right sole is still a mess. And why is my left sole better as a result, but not the right? I am going to try piano felt in the many different shoes I wear (most with leather uppers), but I still want to find out what the allergy is. I am seeing my dermatologist soon, but I don't think she knows much about shoe materials. Perhaps my podiatrist can help. One other detail: this all started after I was treated for athlete's foot with Ketokonazole. Any insight would be appreciated! Thanks.

[Dr Rajput]

Hi, the probabilities of the rashes and crack on sole are Atopic dermatitis, Contact dermatitis, sweat dermatitis, seborrheic dermatitis and drug reaction or infection. It could be reaction to ketoconazole. Also any previous history of eczema, asthma, and allergic rhinitis should also be taken in to consideration. Metal allergy can also be strong possibility.

Glucocorticoids with anti-histaminics against prescription may help to alleviate these symptoms. Try using soft, non- metallic foot wears.

Second thing to rule out is fungal reinfection which is often seen with physical activity resulting in copious sweating, unhygienic conditions, reduced immunity status like diabetes, steroid therapy etc. Even, obesity predisposes to this condition.

I suggest you to consult allergy specialist. Take care and regards.