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What Does Thin, Flaky And Yellowish Skin On Feet Soles Indicate?

Posted on Wed, 29 Apr 2015

Question: Hi. The soles of my feet are almost totally covered with this think, flaky, yellowish layer of skin. It itches sometimes, but no burning feeling. It started out just on my heels and was easy to sand away with a pumice stone, but it's gotten bad lately--and covers almost my whole sole now. It also seems to return quicker after sanding than it did before. Do you think the pumice stone itself has become infected with whatever it is? Can I disinfect it somehow instead of buying a new one every day? What do you think the problem is with my feet? I will take a picture with my webcam and attach it to this email. Thanks for your time! --XXXX

Answered by Dr. Hardik Pitroda (55 minutes later)

Brief Answer:
Topical corticosteroid and salicylic acid

Detailed Answer:
Hello,
Thank you for posting on HCM.
I can understand your concern regarding the skin lesions.
I have reviewed your clinical pictures and it seems very likely that you are having a type of eczema called planter keratoderma.
It can be caused due to contact with detergents, soap, due to conditions like diabetes, thyroid disorders and in may cases hereditary.

In my patients, I generally advise some basic investigations like blood counts, blood sugar, thyroid hormones etc to rule out any underlying chronic condition. As for the treatment, I advise application of creams containing potent corticosteroid and salicylic acid and urea or coaltar based creams. These medications will eventually remove and exfoliate all dead skin layers rendering smooth and healthy skin.
Apart from these, always apply a good moisturiser over your feet and soles and use moisturizing soap or bodywash on daily basis.
Avoid contact with strong chemicals like detergents etc.

I am sure you will be fine soon.
Take care
Dr Hardik Pitroda

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Hardik Pitroda (1 hour later)

Dr. Pitroda,

Thanks for answering my questions. When you told me that I may have plantar keratoderma on my feet, it reminded me that I was recently diagnosed with keratosis pilaris (on arms and legs only). What's the difference between the two? They have the same "kerato" root word, and the same treatments are reccomended for both, so are they related? They look NOTHING alike.
I hate to second-guess you, but my research led me to believe that I have some sort of fungal infection on my feet. Are you pretty positive that it really is keratoderma?
I think I need a more potent topical cream than I can get OTC. Could you possibly write me a script for Latrix XM emulsion cream, which is %45 urea? I have no idea if that's possible or not.

Thanks! XXXXXXX

Answered by Dr. Hardik Pitroda (10 hours later)

Brief Answer:
KOH mount to rule out fungal infection

Detailed Answer:
Hello XXXXXXX
Yes this seems definitely like keratoderma.
Keratoderma can be secondly infected with fungus and that possibility is difficult to rule out clinically but usually isolated fungal infection of legs is unilateral but both feet can be involved.
Confirmation of fungal infection requires a special investiagtion called KOH mount and culture from skin scrapping.
Keratopilaris and keratoderma are both disorders of keratinization i.e process of formation of new skin layers. Thus both the conditions can coexist.
I am sorry its not possible for me prescribe medications but you can consult a dermatologist and discuss the treatment I advised you.
Hope you got my point here.
Let me know if you require any more assistance from my side.
Thank you
Dr Harik Pitroda

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar