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Saturday, January 4, 2020

Painful Feet with Heat Exposure: Opinions Needed!!!

Hello, this is Dr. Blake and I need your help. The following are photos from a patient with extreme foot pain at the areas of redness primarily I believe when she is exposed to heat. This can be normal walking more than a mile, or triggered by hot tubs and hot weather. One suggestion is erythromelalgia from a dermatologist friend. She will be getting a biopsy soon. 


Hi Dr. Blake, 
Attached are the photos we talked about today. 

To summarize the issue: 
~ These episodes seem to be triggered by heat (hot weather, hot tubs) and/or moderate amounts of walking/standing - most of these photos were taken while I was on vacation. 
~ 10/10 pain, which can be described as achy, hot, burning, stabbing, and like a "bruised sunburn" on the soles of the feet
~ Extremely painful to walk or put weight on affected feet/foot (resulting in limping and hobbling) 
~ Feet feel warm to the touch most of the time, but especially during these episodes 
~ Usually feels better after a day or two of rest and air conditioning or moving to a cooler climate, but if air conditioning or moving to a cooler climate is impossible, it can stay like this for days/weeks

Please keep me updated on any interesting possible diagnoses! 

Oh, and here's the foot pain forum that I told you about today (full of other people who have something similar going on): https://www.foot-pain-explained.com/painful-red-spots-on-my-feet.html#comments

Thanks for your help,














Here is a response from one of my patients/friends:

I know you can research anything but here's one: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871369/

Dr. Steve Pribut wonderful post:

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.