Dr Allen L. Hoekman of Harrison, SD, has written as follows: I would appreciate clarification on an inconsistency I've noticed in William Weston's article, "Dermatoses of the Foot" (PIR 1985;7:45). On page 45 and in Table 2, it says that scabies does not involve the plantar surface of the foot. On page 49, it says that scabies can involve the plantar surface (weight-bearing surface). Please clarify.
William L. Weston has replied: I agree with Dr Hoekman that it is confusing in the article as to whether or not the weight-bearing surface of the foot is involved in scabies. Clearly, involvement of the weight-bearing surface of the foot in scabies may occur, although the lesions occur predominantly over the dorsum of the foot and extend onto the ankle. For the purposes of making the algorithm in the article work in a simple manner, scabies was placed in this category to help with rapid diagnosis. However, it is clear that scabies can involve the weight-bearing surface of the foot; involvement of this area does not exclude the diagnosis. The algorithm would have perhaps been better if I had included a separate category for involvement of both the sole and the dorsum of the foot, but I believed this would have made the algorithm too complex.