A middle-aged woman was presented to the clinic with a complaint of very painful heels. Her limping was not due to the typical heel spur syndrome that is generally seen. She had severe cracks and fissures on both of her heels. Her heels had gradually become thicker over the last six months and felt hot and painful to the touch. Previous medical history: She was unaware of any other family members with a similar condition and had tried cocoa butter and abrasive instruments to reduce the hyperkeratosis. Several deep cracks had developed in recent weeks.
She denied any significant past medical history. She was a former smoker. She denied taking any medication other than vitamins A and D, magnesium and calcium at simple supplement dosages. Physical examination: Remarkably, the soles were quite warm at 97degrees Fahrenheit. The general examination of the skin revealed opaque, yellow to white…
