Juvenile Plantar Dermatosis
Juvenile plantar dermatosis is one of the most frequent diseases related to atopic dermatitis. It is observed with greater prevalence in pre-adolescence, between 3 and 15 years of age, as indicated by the Spanish Association of Pediatrics.
It is characterized by inflammation of the sole of the foot and, to a lesser extent, of the palms of the hands. In addition, itching (itching) is often so intense that a differential diagnosis must be made with tinea pedis ( athlete’s foot ) and plantar psoriasis.
What are the causes of juvenile plantar dermatosis?
Juvenile plantar dermatosis is more prevalent in people with a history of atopic dermatitis. Furthermore, it occurs more frequently in children, with a mean age of 8 years. Some of the suggested causes are as follows:
- Constant frictional movements.
- The excessive sweating, also called hyperhidrosis, can cause the foot to remain in damp conditions.
- Closed shoes, mainly made of synthetic, plastic or waterproof materials.
- Genetic predisposition and skin hypersensitivity.
- Seasonal changes : there is an aggravation during the summer months due to excessive sweating and heat, and during the winter months due to the use of closed shoes.
Manifestations of juvenile plantar dermatosis
As its name implies, juvenile plantar dermatosis affects the soles of the feet, except for the plantar arch and interdigital spaces. It usually manifests bilaterally and symmetrically and sometimes, as evidenced by this study published in the Acta Dermato-Venereológica , affects the palms of the hands and fingertips.
The skin is red, shiny, painful and itchy constantly, causing intense itching. In addition, this type of lesion does not show exudation, but it is possible to observe moderate desquamation of the affected regions.
Sometimes painful fissures and cracks predominate, aggravated by moisture and excessive sweating typical of the affected foot.
Complications of juvenile plantar dermatosis
The most frequent complications that can develop during juvenile plantar dermatosis are cracks in the skin and painful fissures. In fact, both can take weeks or months to completely heal and regenerate the epithelium.
Sometimes, when hygiene is not adequate, a secondary bacterial skin infection can be triggered. In cases where the skin is affected up to the periungual area, nail dystrophy may be observed in the future.
Differential diagnoses to be discarded
The clinical manifestations of juvenile plantar dermatosis are similar to those of other dermatological pathologies. Therefore, when making a diagnosis, the following diseases should be ruled out:
- Palmoplantar psoriasis.
- Palmoplantar dyshidrosis.
- Atopic dermatitis.
- Athlete’s foot.
- Allergic contact dermatitis.
- Exfoliative keratolysis.
In case of doubt when making the diagnosis, a mycological exam can be used to rule out diagnostic possibilities.
How is the diagnosis made?
The diagnosis of juvenile plantar dermatosis is made at the time of consultation with the dermatologist. Therefore, it is the findings in the patient’s clinical manifestations that will determine the pathology.
If some type of diagnostic test is needed, skin scrapings can be performed to rule out a mycological cause. In addition, to rule out contact dermatitis, contact testing can be performed. Biopsy is generally not required for this type of condition.
What are the therapeutic options?
There is no specific treatment for juvenile plantar dermatosis. In fact, it is a pathology that, once the condition is resolved, usually reappears at some point.
Reduce shoe friction
You should opt for shoes of the correct size and wear 100% cotton and breathable socks, as synthetic ones do not help to solve the problem.
If possible, try not to wear athletic shoes for too long, especially after perspiring. On occasions when sweating is excessive, it is recommended to change the socks regularly to avoid the formation of a humid environment.
moisturize the skin
As with all pathologies of atopic origin, the usual and constant hydration of the skin is recommended as the first line of treatment .
After every bath or before bedtime, the skin should be properly hydrated. In fact, creams with petroleum jelly or urea can be used for the soles and heels.
cream prescription
In cases where there are fissures and cracks, the use of tacrolimus or corticosteroid ointments can be very helpful. Topical corticosteroids are compounds that should not be used for more than 10 days, nor in the usual way because of their great adaptability to the skin and their adverse effects with prolonged use.
However, it is always recommended to consult a health professional to resolve any doubts that may arise and to receive the appropriate diagnosis and treatment for each case.
