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fourth toe, right foot, with blister , dark skin and pain


Dear Doctor. My mother is 82 years old. Between 3 and 4 months ago, she developed a pain in her fourth toe, right foot. Two months ago I took her to a dermathologist, the dermathologist removed a bunion on the fifth toe. It seeemed that the bunion pressed the fourth toe. In another clinic the doctor said that she needed surgery to remove a bone growth that caused the problem. At least since two months ago, she developed a big blister between the fourth and fifth toe, with liquid oozing and bad smell. A doctor recommended sulphas application. One month ago I took her to a traumatologist who took an x-ray and said there was no justification for surgery because there was no bone growth. Traumatologist said she has claw-toes and advised to clear an insole and if it did not allevaiate the problem, to return for a special contraption to be designed for her foot. Another doctor examined her a week ago and said that she has fungus and provided an anti-micotic cream. I asked my mother to stay without shoes for several hours a day and apply sulphas and the anti-micotic cream, the blister started to close, liquid stopped oozing and no more bad smell. It seems that it is is not completely closed, but at least it is better than two weeks ago. Important point, all the time she has a slightly darker colour in her fourth toe, than the rest of the foot.
Six years ago she underwent radical mastectomy on one breast.
For several years she has seen her right foot kind of enlarged at the ankle, it has been repeatedly indicated by several doctors that there is poor blood circulation in her foot. What is most frustrating for me, after consulting dermathologist, traumatologist, internal medicine specialists, that there is no clear cut diagnosis. I am thinking of taking her to a podiatrist. Kindly advise. Thank you Doctor.


  1. There are several things that come to mind. First it is not unusual to find an 82 year old with bad circulation to the legs and feet. The color changes may be an indication of this. I am not sure what the doctor who operated on her did, but it was either a hammertoe or a tailor’s bunion. The drainage afterward might indicate a bone infection at worst. I think if there is no podiatrist, then see if you can take her to an orthopedist. Good Luck

  2. Thnak you Doctor. A podiatrist examined her yesterday and found that due to her age , soft tissue normally found around under toes’ skin is reduced thus increasing the collision between the bones and skin. A sore blister was produced on her fifth toe, then disappeared, and a new blister appeared on her fourth toe. Podiatrist cleaned the wound, removed thin bunion that grew around the blister with a scalpel, dabed some antibacterial cream, wrapped the toe in gauze and an elastic bandage and placed a gel interdigital separator. Then she could put on her shoes w/o pain and could walk. I bought some wide shoes and she feel fine now. She will clean the wound every day with the liquid used before operations, add the antibacterial cream and use the interdigital gel separator. Follow up in one week. Poor circulation had no relation to this problem, the root cause was that soft tissue being reduced the chance of collison between bones and skin was greater and produced the blisters and bunions. Thank you Doctor.

  3. Doctor, thank you. Can you give me some tips on what on your opinion might be the root cause of the problem based on the symptoms I described? I live in Peru. Thanks again.