Patient came in with red, extremely itchy blisters on the top of his left foot that started 1 month ago. He had gone to a ‘fast-clinic’ inside a pharmacy and was diagnosed with herpes. He took oral antiviral (acyclovir) tablets and the area seemed to get better. Unfortunately, a week later, the rash returned. It was intensely pruritic.  I asked if he has the rash anywhere else and he said “yes, on the same exact spot on the other foot!” I asked him if he had done anything unusual before the rash reappeared.  He said, “Not much, only my bowling league”.

What’s your diagnosis?

Diagnosis: Allergic Contact Dermatitis to his new bowling shoes

Allergic contact allergy testing demonstrated a positive reaction to epoxy resin, a glue commonly used in the shoe industry.
He switched to epoxy free shoes and the problem resolved..

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