PIEZOGENIC PEDAL PAPULES IN A YOUNG FEMALE
Iffat Hassan, Peerzada Sajad
Corresponding author: Associate Professor Iffat Hassan e-mail:firstname.lastname@example.org
We hereby report a case of a 28 year old female who presented to us in the outpatient Department of Dermatology, STD and Leprosy SMHS hospital (associated teaching hospital of Govt. Medical College Srinagar) with complaints of appearance of multiple painful skin coloured swellings over the heels and lateral borders of both feet since the last 8 years (Fig. 1). They became progressively more painful on walking or standing for long periods. These swellings used to disappear on lying down, and lifting feet of the ground. There was no other significant medical or surgical history. On examination the patient was obese with a body weight of 83 kgs,with normal systemic and cutaneous examination. Tender skin coloured papules and nodules (0.5×2cm) were appreciated over the heels and lateral borders of both feet in standing position, which disappeared as the patient was made to lie down. Piezogenic pedal papules is a condition that occurs in individuals after prolonged standing or running and is presumed to result from herniation of fat through connective tissue defects. Patients are usually males. Lesions commonly occur as bilateral flesh-coloured, asymptomatic papules over the medial and lateral aspects of the heels. They become apparent only when the body weight is borne by the heels. Lesions are also reported to occur on the wrists. Sometimes they may be painful. Biopsies show fragmentation of dermal elastic tissue and herniation of subcutaneous fat into the dermis. Treatment consists of weight reduction, use of foam rubber footpads or foam-fitting plastic heel cups, avoidance of both long periods of standing and excessive trauma, and surgery.
Figure 1. Piezogenic pedal papules over the lateral border of left foot