Q: I have had a rash on the tops of my feet for almost two years. My primary physician and my dermatologist do not know what it is. I have used athlete’s foot medication, Benadryl cream, alpha hydroxy creams, hydrogen peroxide, and almost every moisturizer on the market.
This is a dry, red rash. No blisters. It is not between my toes, nor is it on the bottom of my feet. I do not spend any significant amount of time in the sun, especially this time of the year, as we live in a cold winter climate. I have COPD. My current medications are Azythromicin 250 mg every other day, Combivent and Qvar daily, Mucinex 1200 mg as needed, and Furosemide 20 mg as needed. If antibiotics, fungi and virus medications do not work, what could?
A: The first two things that come to mind are a medication reaction or a possible allergy. To begin with, Azythromicin is an antibiotic that fights bacterial infections but may be prescribed for other purposes. My guess is, you are taking it because of infection. Side effects may include dizziness, palpitations, a severe skin reaction, itching, and more. It also is known to interact adversely with numerous medications, OTCs, vitamins, and herbs. While unlikely, it is a possibility! Mucinex is an expectorant prescribed to relieve or reduce the symptoms of cough. Adverse side effects may include itching, rash, and hives. Again, while unlikely, it remains another possibility! The Combivent, Qvar and Furosemide you have been prescribed do not appear to cause the symptom you are experiencing.
So, your first step is to make an appointment for a second opinion to determine if your rash could be medication-related. If this is a possibility, ask your physician if he or she will consider recommending the discontinuance of one medication at a time. Or, perhaps there is another medication in each class that does not have the unwanted potential side effects noted. The reason for not discontinuing both at once to make you improve faster, is because you won’t be able to determine which medication is to blame. By stopping one for a period of time, you can determine if there is any modification. If there is no change noted within a reasonable period, you can go back on the prescription and discontinue the second one following the same plan.
Lastly, the tops of a person’s feet are extremely sensitive. An observation I have made is that some shoes — particularly those manufactured in foreign countries ––are often treated with chemicals to keep them soft and pliable. Unfortunately, this process can have an adverse reaction on the tops of your feet. The bottoms of your feet will likely remain unaffected because there is a liner, even in sandals, that acts as a barrier and prevents a rash. The only concern I have here is that two years is a long time, unless you are affected by a favorite pair of slippers, boots, or shoes you wear year-round. If this is a possibility, put the shoes aside (as in the trash bin) and refrain from wearing others that may be in the same category.
