Itchy patch on left foot sole (and not responsive to several cream)

I'm a 22 years old male teenager. Since a year ago I've had this reddish (could be purplish) circular patch on the sole of my left foot, near the foot arch. It's about 3 cm in diameter, slightly raised and itchy, but it doesn't have any skin peeling or smell that's associated with fungal infections I used to have. It's aligned to the region between the sole and the normal skin that cover the top of the foot, and doesn't spread towards the top of the foot. I'm not sure if it can spread either, since the itchy region has remained about this size for several months. I've scratched it a lot so it's kinda hardened compared to other parts of my sole.

I've seen a few doctors, of which one carried out a skin scraping test (I think) and it was negative, and according to that doctor it's unlikely to be tinea keratosis. In fact, the itch appears to be more skin-deep, since blisters that formed directly on the patch as a result of scratching and eventually healed did not leave the area with an unaffected zone.

The doctor suspected that it could be fixed drug eruption, but the only drug I've taken, and on rare occasions when I fall sick, are normal paracetemol and chlorpheniramine tablets. Recently I noticed a new patch near the old one (about 2 cm away), with the same slight darkened skin tone of about 0.5 cm in diameter and itch.

The following creams are the ones I've used for around 2 weeks to a month each to no avail:

miconazole nitrate (micronised)  2% w/w
miconazole nitrate mixed with steroid
betamethasone valerate cream BP 0.025% w/w
betamethasone valerate cream BP 0.05% w/w

By no avail, I mean these cream doesn't remove the itch, and doesn't cure the problem.

Can anyone identify this skin problem of mine?

[Bhupinder Kaur, MD]

Hello,
The symptoms nummular dermatitis and granuloma annulare need to be ruled out. Granuloma annulare is a chronic disease consisting of a rash with reddish bumps arranged in a circle or ring. Usually it is asymptomatic but due to cosmetic disfigurement topical or oral steroids may be needed. Please discuss this with your dermatologist.

I hope it helps. Take care and please do keep me posted in case you have any additional doubts. Kind regards.

[ravian]

Any suggestions of the possible skin problem associated with it? It doesn't have any skin peeling (except when I scratch it really really hard), and it's just one smooth darkened patch, not a cluster of small bumps/dots.

[ravian]

http://ui.abimg.net/images/answers/431220/2406136/foot.jpg?1296084485a

An image I found online, mine looks similar, except it's darker, and on the arch of the foot (shift the patch to the right)

[Bhupinder Kaur, MD]

Hello,
It can be due to granuloma annulare. If it is itchy then tinea pedis is an important possibility. Granuloma annulare is a chronic disease consisting of a rash with reddish bumps arranged in a circle or ring. Usually it is asymptomatic but due to cosmetic disfigurement topical or oral steroids may be needed.
I hope it helps. Take care and regards.