What is the cause of heel pain and scaling at the heel of the foot?

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Differential Diagnosis for Scaling and Pain at Heel of Foot

  • Single most likely diagnosis
    • Plantar fasciitis: This is the most common cause of heel pain and can be associated with scaling due to increased friction and pressure on the heel. The pain is typically worse in the morning and improves with activity.
  • Other Likely diagnoses
    • Heel fissures: Dry skin and increased pressure on the heel can cause fissures, leading to pain and scaling.
    • Achilles tendinitis: Inflammation of the Achilles tendon can cause pain and stiffness in the heel, which may be accompanied by scaling due to altered gait or increased pressure.
    • Psoriasis: This chronic skin condition can cause scaling, redness, and pain on the heel, especially if the skin is thickened or cracked.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Osteomyelitis: A bone infection that can cause pain, redness, and swelling in the heel, which may be accompanied by scaling or discharge.
    • Tumor (e.g., plantar fibroma): A rare but potentially serious condition that can cause pain and scaling on the heel.
    • Deep vein thrombosis (DVT): Although less common, DVT can cause pain and swelling in the heel, which may be accompanied by scaling or discoloration.
  • Rare diagnoses
    • Sarcoidosis: A systemic disease that can cause skin lesions, including scaling, on the heel.
    • Erythromelalgia: A rare disorder that causes burning pain, redness, and scaling on the feet, including the heel.
    • Pachyonychia congenita: A rare genetic disorder that causes thickening of the skin on the feet, including the heel, leading to pain and scaling.

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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