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Have burning sensations, stinging and abrasion on toes. Have put calamine and taken tramadol. Suggest?

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General & Family Physician
Practicing since : 2005
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I have the most painful sensations of burning, stinging and abrasions in bith my big toes. The intense pain comes and goes in a throbbing sensation. I have put some calamine and lignocaine on and taken 100 mgs Tramadol to no avail. The pain is so intense it has awoken me. I have had this pain before and recently I also had chilblaines but tonight the pain is really awful.
the skin on the toes around the cuticle area is not red or inflammed just very tight and shiny.
Posted Wed, 31 Jul 2013 in General Health
Answered by Dr. Prasad 2 hours later

From what I understand you have a severe burning/stinging pain with abrasion in between your big toes. Calamine, lignocaine and tramadol have not helped you. You could have mentioned since when you have this pain and whether or not you have any color changes on the skin/nails.

The most likely possibility which I can think of is "intertrigo". It refers to inflammatory condition of toe folds/webs commonly caused mainly by fungal organisms. Secondary bacterial infection can worsen the symptoms. Calamine, lignocaine or tramadol has no effects on the condition. You can try combination - antifungal and antibiotic agents, instead of lignocaine/calamine. Nystatin containing products have antifungal and antibiotic properties - your pharmacist will know about nystatin.

If there are dark color changes, then the condition needs to be brought to notice of your doctor at the earliest.

Hope this answers your query. Let me know if you need clarifications.

Above answer was peer-reviewed by
Follow-up: Have burning sensations, stinging and abrasion on toes. Have put calamine and taken tramadol. Suggest? 17 minutes later
I have had the condition off and on for about 6 months. I clarify that apart from having very bad circulation due to L4 and L5 laminectomy in 2001 and a total knee replacement in 2004, my feet are totally fungus free. I regularly attend a podiatrist and I had not chilblaines since 1950s when I was in UK aged 16 until this winter in Australia which has been extremely cold. The podiatrist told me he could see absolutely nothing wrong with my skin and could not explain the pain and sensation of burning. There seems to be nothing abnormal in the look of the skin with the excepttion of several other toes, where there is still discolouration from the chilblaines which are otherwise healing nicely. I am wondering whether there is some neurological condition and would appreciate advice on whom I could best consult on the matter a dermatologist or a neurologist. And what can I do to stop the intense pain and burning sensation please.
I am sorry I did not clarify that the condition is not between the big toes, it is on top of the toes going up to the tarsal area of my feet, just the top surface and the worst part of the pain is immediately above the cuticle.
Answered by Dr. Prasad 9 hours later

Apologies for the late reply...

I noted the podiatrist findings. I have couple of comments here:

1. If there is nothing wrong on the skin - color and texture changes - then yes it is unlikely to be fungal infection. But if the skin around the cuticle is stretched and shiny, we need to rule out local toe conditions before exploring neurological problem per se. Stretchy and shiny skin is an indication of underlying odematous collection which is very commonly in inflammatory conditions. You can discuss with your dermatologist to clarify about inflammations straightaway or watch out for gradual changes to take specific actions.

2. Peripheral neuropathy can cause paraesthetic pain such as the ones you mentioned. We can check your blood sugar, thyroid profile, vitamin B12, Vitamin D level apart from peripheral pulses check to know if any of these can be the cause of peripheral neuropathy. If test results prove what you have is indeed neuropathy, then the neurologist first. He/she can examine the toe, check your peripheral pulses and guide you through the test. If there are no localised problems found, they can start you on selective serotonin reuptake inhibitor group of drugs which should take care of this annoying pain.

Hope this information is detailed and guides you towards recovery. Let me know if you need clarifications.

Above answer was peer-reviewed by
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