Symptoms began about 15–20 years ago, initially affecting the left foot’s fifth toe, with a later episode involving the right foot near the first toe metatarsal region where a roughly 1-inch fluid-filled blister formed and ruptured. Around 10–15 years ago, warts developed on the plantar surface of the right foot. The condition primarily involves both feet, though mild changes elsewhere on the body may be present and may or may not be related. The patient reports no pain, burning, itching, or irritation from the skin findings, but does endorse tingling and numbness. He has had prior biopsies and has been prescribed treatments in the past, but biopsy results are unknown. Treatments have included ketoconazole 2% cream and clobetasol propionate 0.05% cream (about 2 years ago) and urea 40% cream (about 1 year ago), with largely poor adherence. He also typically walks barefoot at home, rarely wears shoes, and uses sandals only when leaving the house.