Piezogenic pedal and palmar papulosis

European Journal of Dermatology. Volume 12, Number 4, 369, July - August 2002, Cas cliniques

Author(s) : K.S. LESLIE, C.E. GRATTAN, Department of Dermatology, Norfolk & Norwich University Hospital, Colney Lane, Norwich. NR4 7UZ, United Kingdom..

Summary : A 22-year-old Caucasian woman was referred to our department with asymptomatic papules around the sides and insteps of both feet. The papules had developed over the preceding 12 months. They were only present when the patient was standing (Fig. 1). She had also noticed that if she stretched the skin over her hypothenar eminences similar papules became evident (Fig. 2). As the papules were asymptomatic surgical excision was not considered for our patient.

Keywords : piezogenic pedal papules.

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ARTICLE

Comment

Piezogenic pedal papules are a relatively common finding in healthy subjects [1, 2]. It is usual for them to appear when standing and to disappear when weight is taken off the foot [3]. They tend to be asymptomatic although occasionally they can be painful. Histology just shows normal adipose tissue [4]. It is not clear why the papules are occasionally painful although various reasons have been considered, including ischaemia due to extrusion of fat within its vascular and nervous supply [5].

As far as we are aware this is the first case report with concomitant palmar papules. Excision of solitary papules should be considered if they are painful and this may be curative [6].

Article accepted on 21/1/02

REFERENCES

1. Kohn SR, Blasi JM. Piezogenic pedal papules. Arch Dermatol 1972; 106: 597-8.

2. Zaidi Z, Jafri N, Noori B, et al. Piezogenic papules a study of 100 cases. J Pak Med Assoc 1995; 45: 93-4.

3. Cohen HJ, Gibbs RC, Minkin W, et al. Painful pedal papules. Arch Dermatol 1970; 101: 112-3.

4. Sclappner OLA, Wood MG, Gerstein W, et al. Painful and non-painful piezogenic pedal papules. Arch Dermatol 1972; 106: 729-33.

5. Shelley WB, Rawnsley HM. Painful feet due to herniation of fat. JAMA 1968; 209: 308-9.

6. Ronnen M, Suster S, Huszar M, et al. Solitary painful piezogenic pedal papule in a patient with rheumatoid arthritis. Int J Dermatol 1987; 26: 240-1.