Question: My orthopedic surgeon has diagnosed the lumps under my foot as Ledderhose’s disease, but says there is not much that can be done for it. Can you tell me more about this condition?
A fibrous sheet (the plantar fascia) stretches under the skin of the sole to give it a smooth appearance, strength and firmness, and to protect and control the movement of the muscle tendons that cross under it to the toes. If damaged, the plantar fascia may become scarred, contract and thicken into hard lumps that can be felt under the skin. As the damage progresses, the contraction of the fibrous sheet pulls on the tendons that run underneath it to prevent their free movement. This is Ledderhose’s disease. Men are affected more than women, and a similar condition (Dupuytren’s contracture) occurs in the hand.
The cause is unknown, but may be due to a poor blood supply to the foot (eg. diabetes), and injury to the foot from repeated blows (eg. running). The symptoms include one or more hard, fixed nodules under the skin of the sole that gradually extend lengthwise along the sole to cause discomfort, pain with walking and loss of toe mobility. Eventually the toes cannot be fully extended, and contract into a claw-like appearance. The middle toes are usually more severely affected than the others. Treatment involves soft shoe insoles, injection of steroids around the nodule, and in severe cases only, the nodule may be surgically excised. Unfortunately, recurrence after surgery is common, and the lumps are usually persistent.

Question: The soles of my feet get very dry, scaly and itchy, particularly in summer. Sometimes there are tiny pimples present at the sides of the foot. Fungicidal creams do not help. What is it and how should it be treated?
Dyshidrosis (also known as pompholyx) is the condition that fits your description. It is a form of eczema that is associated with excessive sweating (feet sweat in shoes), but may also be aggravated by anxiety, stress, fungal infections and chemicals that contact the area.
The small vesicles that develop are often described as small boiled rice grains under the skin. If the cause of the problem can be removed (eg. wear sandals instead of shoes to reduce sweating) the condition will slowly resolve, but often the cause cannot be determined and it is necessary to use various medications to control the itching and irritation. Potassium permanganate foot baths are messy but effective. Other treatments include steroid creams and steroid tablets in severe cases.

Question: I suffer constantly from cold feet, mainly when in bed, and have been told it is a medical problem. I await your comments.
Cold feet are usually due to poor circulation of blood to that area. If insufficient warm blood reaches your feet, they will feel cold, and may be white or blue, and painful. In older people, hardening of the arteries (atherosclerosis), heart failure and diabetes are the main causes of poor circulation, while in younger people, spasm of an artery may be responsible. Raynaud’s phenomenon is a condition in which arteries go into spasm, narrow down, and fail to supply adequate blood to the hands or feet, which become cold and painful.
As you can see, a number of conditions may be responsible for your problem. You will need to be investigated to determine which problem is affecting you. Once this is known, the appropriate treatment can be given to cure or control the disease.