The clinical image of the foot shown above demonstrates erythematous, scaling, and vesicular lesions, some with erosions and crusting. Which of the following is the most likely diagnosis?

Question

Accepted Answer

A. Tinea Pedis. ## Image Findings
*   Erythematous patches and plaques on the dorsal aspect of the foot and toes.
*   Scaling, particularly visible on the toes and interdigital areas.
*   Multiple small vesicles and bullae, some ruptured, leading to erosions and crusting, especially on the dorsal foot.
*   Irregular, somewhat serpiginous borders of the lesions.

## Diagnosis
**Key Point:** The presence of erythematous, scaling, and vesiculobullous lesions, particularly in the interdigital spaces and on the dorsal foot, is highly suggestive of **Tinea Pedis (Athlete's Foot)**.

Tinea pedis is a common dermatophyte infection of the feet. The image displays features consistent with the **inflammatory or vesiculobullous type** of tinea pedis, characterized by pruritic vesicles, bullae, erythema, and scaling. These lesions often occur on the instep, sole, or dorsal aspect of the foot and can be accompanied by erosions and crusting from ruptured blisters. The distribution and morphology are classic for a fungal infection.

## Clinical Relevance
**Clinical Pearl:** Tinea pedis is often associated with hyperhidrosis, occlusive footwear, and communal wet environments. It is a common source of fungal infection for other body sites (e.g., tinea cruris, tinea manuum).

## High-Yield for NEET PG
**High-Yield:** The **vesiculobullous type of tinea pedis** often presents with pruritic vesicles and bullae, especially on the instep or dorsal foot, and can be mistaken for dyshidrotic eczema or contact dermatitis. A **KOH mount** is crucial for diagnosis.

**Key Point:** **Trichophyton rubrum** is the most common causative organism for tinea pedis.

## Common Traps
**Warning:** Differentiating tinea pedis from dyshidrotic eczema or contact dermatitis solely based on morphology can be challenging. Always consider a **KOH examination** to confirm fungal etiology, especially in atypical presentations or when treatment fails.

## Reference
[cite:Rohit, Kumar. (2020). Dermatology. Jaypee Brothers Medical Publishers. Ch 14, Fungal Infections of the Skin.]

Answer

B. Contact Dermatitis

Answer

C. Psoriasis

Answer

D. Dyshidrotic Eczema

The clinical image of the foot shown above demonstrates erythematous, scaling, and vesicular lesions, some with erosions and crusting. Which of the following is the most likely diagnosis?

Explanation

Image Findings

Diagnosis

Differential Diagnosis

Clinical Relevance

High-Yield for NEET PG

Common Traps

Reference

Practice similar questions

Join our NEET PG community

Feature	Tinea Pedis (Vesiculobullous)	Contact Dermatitis	Dyshidrotic Eczema (Pompholyx)	Psoriasis (Pustular)
Lesion Morphology	Erythema, scaling, vesicles, bullae, erosions, crusts, often unilateral	Erythema, vesicles, bullae, edema, well-demarcated	Deep-seated vesicles/bullae, pruritus, often bilateral, palms/soles	Erythema, scaling, pustules, often bilateral, well-demarcated plaques
Distribution	Interdigital, plantar, dorsal foot; often unilateral	Area of contact with allergen	Palms, soles, lateral fingers/toes; often bilateral	Extensor surfaces, scalp, nails; can affect soles
Key Feature	Fungal etiology (KOH positive), often pruritic	History of exposure, patch test positive	Recurrent, stress-related, non-infectious	Silvery scales, Auspitz sign, nail pitting