Dermatology Expert Forum
Toe Problem
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Toe Problem

I have had a rash of some kind on my one big toe for a number of years (over 2). It has not spread and has not increased in size over the past year. It can be itchy and peel at times. Once it has been scratched it can bleed slightly. Please see images below. Have tried no treatment at this point but would like to have some identification and potential treatment options.

http://i.imgur.com/33omVKF.jpg
http://i.imgur.com/UmFn2KD.jpg
http://i.imgur.com/eItsGfc.jpg
Tags: Toe, rash
351246_tn?1379685732
Hi!

I am sorry, but the pictures have been removed from the site so I could not see them. I’ll try and answer your query based on the symptoms you have provided.

Since you have a long standing history of two years, I would for all practical purposes, rule out bacterial infection. Usually bacterial infections would not persist for so long without spreading. Also, they would be really painful, even if for some reason they were contained in the toe region. Also, there would be formation of pus pockets or abscess. However, only culture of the peels can confirm that.

The first possibility is fungal infection. The fungal infection can be due to candida or Tinea. Other fungal infections are less common. The symptoms can be an itchy peely lesion that bleeds on scratching. The diagnosis is confirmed through KOH preparations or through cultures. This can be treated with anti-fungal creams. Many treatment options are there like Clotrimazole 1%, Miconazole nitrate 2%, Tolnaftate 1%, ketoconazole, terfibnafine and Butenafine hydrochloride 1%. Many OTC products containing these salts are available, your pharmacist can help. Try a combination of two and apply until the peeling and itching disappears completely.

After the itch and peel goes, you have to continue applying for at least another 2 weeks for the infection to be completely cured from the lower most layer of the skin. Wash your hands well and dry them properly both before and after the application. Meanwhile test for blood sugar level to see if it is high for diabetes too can prevent resolution of fungal infection. Take any anti-allergic tablet or antihistamine to overcome itching. However, I would request you not to start any treatment on your own. It would be best to consult a doctor because at times you need an oral anti-fungal preparation as well.

Other possibility is eczema or dermatitis. This can also cause itchy and peely lesion that bleeds on scratching. Treatment is by application of steroid and anti-allergic creams and taking anti-histamines or steroids orally too. Emollient creams to keep the area soft too can be used as a part of the treatment. Again, please do not try any treatment on your own.

In general keep the foot clean. Check your foot-wear to see whether the toe is under any pressure or not. Wearing loose comfortable foot wear helps during any foot treatment. Avoid excess sweat in the area. This can be done by wearing comfortable cotton socks with your shoes. Also wash your foot daily and dry it well.  Check your daily routine to see if the toe comes in contact with something your skin is allergic to.

Please consult your family doctor or GP regarding this. You may need to consult a skin specialist too. Hope your toe heals soon! Good Luck and take care!
4 Comments
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Avatar_f_tn
Try this link please...

http://imgur.com/a/8N0Ra
http://www.medhelp.org/posts/Dermatology/Toe-Problem/show/2072004?camp=27#
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351246_tn?1379685732
Ok great--could see now--yes, looks like fungal infection, but please show this to your doctor too.
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351246_tn?1379685732
On second thoughts, it could also be a psoriatic patch.
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