What causes thickening and cracks on the heel of the foot, also known as heel fissures (cracks in the skin)?

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Differential Diagnosis for Thickening and Cracks on Heel of Foot

  • Single most likely diagnosis
    • Callus: This is the most likely diagnosis due to the common occurrence of calluses on the heel of the foot, which are caused by repeated friction and pressure. The thickening and cracks are characteristic of a callus.
  • Other Likely diagnoses
    • Dry skin (xerosis): Dry skin can cause thickening and cracking, especially on the heels. This condition is common, especially in dry environments or with excessive washing.
    • Eczema (atopic dermatitis): Eczema can cause thickening and cracking of the skin, and the heel is a common location. Itching and redness are often associated with eczema.
    • Psoriasis: Psoriasis can cause thickening and cracking of the skin, and the heel is a common location. Other symptoms include redness, scaling, and pitting of the nails.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Diabetic foot ulcer: Although less likely, a diabetic foot ulcer can present with thickening and cracking of the skin, and it is crucial to diagnose and treat promptly to prevent serious complications, such as infection and amputation.
    • Squamous cell carcinoma: This type of skin cancer can present with thickening and cracking of the skin, and it is essential to diagnose and treat promptly to prevent serious complications.
  • Rare diagnoses
    • Keratoderma: This is a rare genetic disorder that causes thickening of the skin on the palms and soles, including the heel.
    • Pachyonychia congenita: This is a rare genetic disorder that causes thickening of the skin on the palms and soles, including the heel, as well as nail abnormalities.
    • Arsenic poisoning: Chronic arsenic poisoning can cause thickening and cracking of the skin, including the heel, although this is a rare condition.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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