Pododermatitis with swollen painful feet
Always check the pre-scapular and popliteal lymph nodes, and if swollen, then consider Demodex and deep bacterial infections.
- Demodex and/or
- Furunculosis with Staph or Pseudomonas
- Deep skin scrapes under sedation and if negative then biopsy is indicated.
- A pluck of hair under oil may reveal mites attached to the hair if you are lucky.
- Culture can be useful but is easily contaminated.
- If no Demodex, a month course of Cephalexin 20mg/kg BID and Pyohex foot baths before re-examining is a valuable first step.
If improved, but still itchy and erythematous, consider furunculosis secondary to allergy.