Throbbing red spot on bottom of foot that comes and goes

by Kelly
(Santa Fe )

I hope you can shed some light on this problem. About 7 years ago I noticed a painful red spot (about an inch wide and an inch long) on the bottom of my left foot. It was very painful, never blistered, and after about 48 hours, disappeared. Over the last 7 years it has returned and disappeared a few times a year. I've gone to one doctor to see if he could explain it, and he had no idea. It seems to develop during the night while I'm asleep. The frequency has increased this year. I woke up this morning with my third one in three weeks. It is very painful to walk when it's there. Also, it kept me up quite a bit last night because of the throbbing. It's always on my left foot, and always in the same spot. It is warm to the touch, and super tender. I'm a 34 year old female with no known health conditions, other than endometriosis. I'm posting two photos. The link to upload a photo is not working. The spot is on the left side of the bottom of my left foot. It wraps up around the side of my foot about a half inch towards my outside ankle bone. The spot horizontally on the bottom and is towards the bottom of my arch.

RESPONSE

Hi Kelly,

I would actually have to see the lesion to have any clue as to what it might be. Try again to upload the pictures. My hosting company is making major upgrades to their system and that may be why you are having difficulty uploading pictures.
The fact that the lesion occurs in the exact same position on the bottom of the left foot tells me that it is probably not a dermatitis (eczema) as most skin reactions to do not limit themselves to the exact same spot every time.
So, if it is not a skin growth of some sort my next thought would be that of a vascular issue, meaning a vein or possibly an artery which is very close to the skin and from time to time gets inflamed and creates the scenario you describe. There is also a condition known as a hemangioma which is basically a conglomeration of blood vessels. It is a benign growth but it too, might be the source of your problem.
As I said I am just guessing here. Even though I do not think it is a skin lesion, per se, I would suggest that when it occurs, you might see a foot specialist and ask to have a small portion biopsied. That would be the definitive way to determine if the problem is within the skin. If the skin biopsy were to come back as negative, then you would have to look at the structures underneath the skin in that location and see what might be causing this issue.
As I am writing this, another thought comes to mind. You do not mention where on the bottom of the foot this lesion is occurring, but if it happens to be on the ball of the foot, then it might just very well be a friction blister that never actually blisters out. Is there any correlation to what you were doing the day before, or the type of shoe that you were wearing that might have precipitated this problem? Think about it to see if you can come up with a common denominator.
Sometimes wearing a very high heel with a thin sole or perhaps doing some kind of athletic activity may have caused this problem and of course the lesion would occur after each episode. So work on that and in the meantime try and upload your pictures.

Marc Mitnick DPM
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