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Itchy top of the foot, scratched until broken, developed large red blisters.

Jan 26, 2024 Source: Cainiu Health
Dr. Wang Xiaoyan
Introduction
In general, itching on the top of the foot that becomes broken from scratching and develops large red blisters may be caused by conditions such as urticaria, eczema, contact dermatitis, tinea pedis (athlete's foot), or herpes zoster. Targeted treatments are required. Urticaria is an allergic reaction, usually triggered by allergens such as food, medications, or insect bites. This allergic reaction causes the immune system to release histamine, leading to blood vessel dilation and swelling of the skin tissues.

Blisters refer to vesicles or bullae. Generally, large red blisters with itching on the dorsum of the foot caused by scratching may result from conditions such as urticaria, eczema, contact dermatitis, tinea pedis (athlete's foot), or herpes zoster. Targeted treatments are required, and it is recommended to seek medical attention promptly for accurate diagnosis and treatment. Specific analyses are as follows:

1. Urticaria

Urticaria is an allergic reaction, usually triggered by allergens such as food, medications, or insect bites. The allergic response prompts the immune system to release histamine, leading to blood vessel dilation and skin tissue swelling. This often results in sudden-onset itching and blister formation. Symptoms may resolve quickly but can also recur repeatedly. Treatment may include topical agents such as Efkang lotion, compound betamethasone and camphor cream, or calamine lotion, as directed by a physician.

2. Eczema

Eczema may be caused by abnormal immune responses, genetic factors, environmental triggers, etc., and commonly occurs in areas of dry skin. It can lead to intense itching and the development of blisters. After scratching, the skin may become red and sometimes exude fluid. Treatment options under medical guidance include prednisolone acetate cream, Binghuang Fule ointment, and dehumidifying anti-itch ointment.

3. Contact Dermatitis

Contact dermatitis is a skin inflammation caused by allergic reactions or irritation from certain substances, such as detergents, cosmetics, or plants. Symptoms may include skin itching, redness, swelling, and blistering, sometimes accompanied by pain. It is advisable to follow medical advice and use medications such as halometasone cream, desonide cream, or hydrocortisone cream to alleviate symptoms.

4. Tinea Pedis (Athlete’s Foot)

Tinea pedis is a fungal infection caused by fungal proliferation on the feet. It may cause itching on the sole or top of the foot, small blisters, and red, moist skin; broken skin is prone to secondary infection. Treatment under medical supervision may include antifungal agents such as ciclopirox olamine cream, liranaftate cream, or terbinafine hydrochloride gel.

5. Herpes Zoster

Herpes zoster is caused by the varicella-zoster virus, which remains dormant in nerve ganglia and reactivates to travel along nerve pathways, causing skin lesions. When affecting the foot, it may present with pain or tingling sensations, followed by red rashes and blisters distributed along the course of the affected nerve. Management based on medical advice may include acyclovir cream, recombinant human interferon α2b injection, or valacyclovir hydrochloride granules.

In daily life, maintaining a light diet and good foot hygiene can contribute to better health.

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