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The response to the question below was authored by Marc Mitnick DPM
Painful, red spots on my feet
I am a 23 year old, female. For years I've gotten red, hot, painful spots on my feet. I get them on my big toe, heel, and sides of my feet. They are very painful and hot to the touch. There's no indication of a skin rash other than the red coloring of the spot. The spots appear overnight and then go away after a couple of days. The spots throb and in the mornings are especially painful to walk on, as the skin feels very tight around them. They are hot to the touch and I am always aware of them. I compare the feeling to having a very bad bruise, that I'm always aware of because it's always throbbing/painful. I went to a foot doctor and after he examined one of the spots, he told me he believed it was gout. I went to a gout doctor and he told me that it was not! I have no idea what to do about them. I get them several times a month and they always range in size and intensity. I can also have more than one on each foot at the same time. Last Summer, on a crazy vacation of constant movement and alcohol, I got the worst "attack" I've had with them. Both of my feet were swollen and I couldn't walk. My feet were basically one giant red spot. It was very painful. By the next day, my feet were back to normal and I just had the "normal" red spots. I haven't had an attack that bad since. I'd love some help figuring this out or at least a point in the right direction.
I will start off by saying that I cannot tell from the picture what your problem is, but from your narrative it sounds like more than just a skin rash.
Most skin rashes will last a period of days to weeks and will gradually clear. Even though you state that these spots go away in a few days you also mention that they have disappeared in as quickly as a day or so.
Secondly most rashes may itch and be uncomfortable but rarely is there a lot of pain associated with them and they certainly do not become hot.
I agree with the gout doctor that is not gout as gout generally occurs in postmenopausal women and in men, not women of your age.
So what am I thinking?
There is a condition known as vasculitis which essentially means an inflammation of your blood vessels either the arteries which carry blood away from the heart, or veins which return blood back to the heart.
Vasculitis can be caused by a number of issue or can be idiopathic, meaning it just occurs for no real reason. I know nothing about your medical history so I cannot venture a guess as to why or what kind of vasculitis you can have.
This condition can also affect different body organs as well as the skin.
I think your best option would be to see a dermatologist either during an event or at least try and take a very good picture of an episode so that the doctor can get a clear visualization of what your foot looks like.
As I said when I started out, I cannot make this diagnosis from your picture but I think it needs to be ruled out by a local doctor in your area.
Marc Mitnick DPM
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