A sole kind of feeling

AT FIRST glance this florid pustular eruption on the sole of the foot could be a severe bacterial or fungal infection. However, a bacterial swab and skin scrapings for fungal microscopy and culture from this lesion will be negative.

This is localised pustular psoriasis. There are neutrophils in the pustules but they are a result of inflammation rather than infection. This condition is treated with a strong steroid cream applied twice a day and under plastic wrap occlusion at night,