Medically reviewed by Dr. Tom Biernacki, DPM — Board-certified foot & ankle surgeon, 3,000+ surgeries performed. Updated April 2026 with current clinical evidence. This article reflects real practice experience from Balance Foot & Ankle Specialists in Howell and Bloomfield Hills, Michigan.
Quick Answer
Most foot and ankle problems respond to conservative care — proper footwear, supportive inserts, activity modification, and targeted stretching — within 4-8 weeks. Persistent pain beyond that window, or any symptom that prevents walking, warrants a podiatric evaluation to rule out fracture, tendon tear, or systemic cause.
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Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Skin conditions of the feet — fungal infections, inflammatory dermatoses, and chronic skin diseases — are a distinct and important component of podiatric practice that overlap with dermatology but have foot-specific presentations and implications. Correctly identifying foot skin conditions prevents misdiagnosis, inappropriate treatment, and the missed diagnosis of more serious conditions (subungual melanoma presenting as nail dystrophy; diabetic foot ulcer presenting as a ‘blister’). The three most common non-infectious and fungal skin conditions of the foot each have characteristic morphology, distribution, and treatment.
Tinea Pedis (Athlete’s Foot)
Tinea pedis — superficial dermatophyte infection of the foot skin — is the most common fungal infection in humans, affecting 15–20% of the adult population. Three clinical patterns: interdigital tinea pedis (the most common — macerated, scaling, white or erythematous skin in the toe clefts, particularly the 4th web space; secondary bacterial infection [Pseudomonas] turns the skin green and produces malodor); moccasin-type tinea pedis (diffuse scaling and hyperkeratosis on the plantar surface and medial and lateral borders — the ‘moccasin’ distribution; associated with Trichophyton rubrum; chronic, difficult to treat with topical agents alone; often accompanied by toenail onychomycosis); vesicular tinea pedis (bullous; intensely pruritic vesicles on the instep and arch; acute presentation). Treatment: topical azoles (clotrimazole, miconazole) for uncomplicated cases; terbinafine cream for moccasin-type; oral terbinafine (250mg/day for 2 weeks) for extensive or recurrent infection; always treat the toenails if onychomycosis is present (toenails serve as the reservoir for reinfection).
Contact Dermatitis and Psoriasis
Contact dermatitis of the foot: allergic contact dermatitis (Type IV hypersensitivity reaction) to shoe materials — most commonly chromate (in leather tanning), rubber accelerators (in shoe soles), and adhesives; presents as pruritic erythema, vesicles, and scaling in a pattern corresponding to shoe contact (dorsal foot in sandal dermatitis; periungual in sock dye allergy); patch testing identifies the causative allergen; treatment: allergen avoidance, topical corticosteroids, hypoallergenic footwear. Psoriasis of the foot: psoriasis may present on the plantar foot as palmoplantar psoriasis — thick, silvery scale on an erythematous base; particularly challenging because plantar psoriasis is often seronegative for the psoriatic plaque morphology seen elsewhere; may mimic moccasin tinea pedis (KOH prep and culture distinguish fungal from psoriatic); involvement of the nails (nail pitting, onycholysis, subungual hyperkeratosis) is highly characteristic of psoriasis and distinguishes it from tinea unguium in ambiguous cases; treatment: topical corticosteroids, calcipotriene, tar preparations; systemic therapy (methotrexate, biologics) for recalcitrant cases. Dr. Biernacki at Balance Foot & Ankle evaluates foot skin conditions with KOH microscopy and clinical examination, and coordinates dermatology referral for inflammatory skin diseases affecting the foot. Call (810) 206-1402 at our Bloomfield Hills or Howell office.
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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
In-Office Treatment at Balance Foot & Ankle
If home care isn’t resolving your your foot or ankle concern, a visit with a board-certified podiatrist is the fastest path to accurate diagnosis and a personalized plan. At Balance Foot & Ankle Specialists, Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin offer same-day and next-day appointments at both our Howell and Bloomfield Hills offices. We perform on-site diagnostic ultrasound, digital X-ray, conservative care, advanced regenerative treatments, and minimally invasive surgery when indicated.
Call (810) 206-1402 or request an appointment online. Most insurance plans accepted, including Medicare, Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare.
Frequently Asked Questions
When should I see a podiatrist?
See a podiatrist for any foot or ankle pain that persists more than 2 weeks, doesn’t improve with rest, limits your daily activities, or is accompanied by swelling, numbness, or skin changes. People with diabetes or circulation problems should see a podiatrist regularly even without symptoms.
What does a podiatrist treat?
Podiatrists diagnose and treat all conditions of the foot, ankle, and lower leg including plantar fasciitis, bunions, hammertoes, toenail problems, heel pain, nerve pain, diabetic foot care, sports injuries, fractures, and foot deformities — both surgically and non-surgically.
What can I expect at my first podiatry visit?
Your first visit includes a full medical history, physical examination of your feet and gait, and in-office diagnostic imaging if needed (X-rays, ultrasound). We’ll discuss your diagnosis and create a personalized treatment plan. Most visits take 30–45 minutes.
Need Treatment at Balance Foot & Ankle?
Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.
Book Online or call (810) 206-1402
Foot Skin Conditions Treatment in Michigan
Balance Foot & Ankle diagnoses and treats skin conditions affecting the feet — athlete’s foot, contact dermatitis, psoriasis, and eczema. Our podiatrists identify the cause and provide targeted treatment.
Learn About Our Skin & Nail Treatments → | Book Your Appointment | Call (810) 206-1402
Clinical References
- Bristow IR, et al. Foot problems in the UK. J Foot Ankle Res. 2010;3:25.
- Thomas J, et al. Terbinafine for onychomycosis and tinea pedis. Am J Clin Dermatol. 2010;11(1):7-18.
- van der Heijden RA, et al. Primary care approach to foot skin conditions. BMJ. 2010;341:c4587.
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Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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Same-week appointments available at both locations.
Book Your AppointmentMost Common Mistake We See
The most common mistake we see is: Waiting too long before seeking care. Fix: any foot pain lasting more than 4 weeks, or any sudden severe symptom, deserves a professional evaluation rather than more rest.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- Unable to bear weight
- Severe swelling with skin colour change
- Fever with foot pain (possible infection)
- Diabetes plus any new foot symptom
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)