Should I be concerned about this birthmark on my foot?

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I understand your concern.

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Is it present since birth? Onset or duration or progress of lesion? Change in size, shape, color noticed? Is there any family history of Melanoma? From the attached photographs (attachments removed to protect the patient's identity), the lesions appear benign. No need to worry. Is biopsy done?

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It is a benign hyperpigmented lesion (Melanosis). No need to worry. Stay relaxed. Take tablet Limcee (Vitamin C) 500 mg once a day after breakfast for 30 days. Wear loose, comfortable footwear. Apply Kojic cream (Kojic Dipalmitate, Potassium Azeloyl Diglycinate, Milk protein) at night for two months. Wash foot daily with lukewarm water and mild cleanser like Episoft cleanser for two months. Wear loose cotton socks. Avoid tight footwear. Avoid injury or trauma to the foot. Follow-up for any doubts. History of atopy or allergies? Contact with irritant or chemical? Any drug history or drug allergies? Are you diabetic? Regards.

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What is your occupation? Is there pain in walking? Calluses? Pain on vertical pressure? It is keratoma plantare sulcatum (ringed or reticulate keratolysis). Differential diagnosis is epidermal verrucous nevi or melanocytic nevus. Biopsy of the lesion is mandatory to rule out malignancy. Use Topical 3 (Clobetasol and Salicylic Acid) percent ointment or gel at night for seven days. You can apply coconut oil or vaseline on foot. Malodor or hyperhidrosis? Have frequent immersion of foot in the water for more than 15 minutes. Are you soaking the foot? Occluded shoes for prolonged periods? Apply Mupirocin 2% ointment twice daily for 15 days on foot. Use Azelaic acid or Aziderm 20 percent cream at night for 15 days or 0.1% triamcinolone Acetonide at night for two weeks. Use Salactin (Salicylic Acid and Lactic Acid Paint) apply under supervision, apply vaseline first as it burns the verruca. Then apply 3% Topisal ointment in the evening for ten days (alternate day). Reduce foot friction with properly fitting footwear, using absorbent cotton socks, wearing open-toed sandals whenever possible, washing feet with soap or antibacterial cleansers twice a day and avoid sharing of footwear.