Heel fissures seem to form at the junction of the two types of skin in the foot, glabrous and hairy skin (for additional information on skin, refer to the Foot and Ankle Knowledge Base at Myfootshop.com). These two types of skin come together at the rim, or junction of the side and bottom of the heel. For most people, the rim is a smooth transition between these two types of skin. For those folks that are over weight, the rim becomes an abrupt turn caused by over loading. This abrupt turn seems to stimulate the formation of callus around the rim of the heel.

Heel fissures are actually a problem that is secondary to recurrent callus formation. As the callus surrounding the rim of the heel thickens, the callus will crack or fissure. Fissures of the heel can become so deep and problematic that the bleed and become infected. Heel fissures can be particularly troublesome for those people that lack sensation in the foot such as diabetics.

Heel fissures have no cure. Prevention is the best medicine. The best that we can hope for with heel fissures is to prevent deep, painful cracks. This requires ongoing

Symptoms:

The symptoms of heel fissures vary based upon the degree of symptoms. The thickness of this unique callus can produce pain.

The majority of problems with this condition come from cracks that become hard to control. The cracks, or fissures, become increasingly deep as the callus thickens. Fissures may bleed and become infected.

Differential Diagnosis: The differential diagnosis for this condition should include;

Abscess

Blister

Benign soft tissue tumor such as a glomus tumor, porokeratoma or eccrine poroma

Malignant soft tissue tumor including malignant melanoma and Kaposi's Sarcoma

Psoriasis

Ulcer

Verrucae

Wart
About the Author

Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle surgeon. Dr. Oster is also board certified in pedorthics. Dr. Oster is medical director of Myfootshop.com and is in active practice in Granville, Ohio.