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Author: Dr Mark Duffill, Dermatologist, Hamilton, New Zealand, 2008. Updated by A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, February 2018.
Idiopathic plantar hidradenitis is an uncommon condition in which there are tender, red lumps on the soles of the feet, and less often, on the palms. It has also been called palmoplantar eccrine hidradenitis and painful plantar erythema.
Idiopathic plantar hidradenitis
Idiopathic plantar hidradenitis mainly affects children and young adults, but it may affect anyone.
The cause is unknown. It is possibly a response to blocked sweat ducts as onset is often associated with heat, exercise, excessive sweating, and prolonged wetness.
Idiopathic plantar hidradenitis is characterised painful red nodules and plaques on the soles and insteps of the feet, and less often, on the palms of the hands. The surface of the skin is unaffected. Walking may be uncomfortable. It is sometimes associated with fever.
In typical cases, no investigations are needed. Skin biopsies of idiopathic plantar hidradenitis may reveal neutrophils around the sweat glands.
Idiopathic plantar hidradenitis should be distinguished from hand-foot syndrome, which may arise in patients with acute myelogenous leukaemia when treated by chemotherapy.
Neutrophilic eccrine hidradenitis is the name given to a chemotherapy-associated eruption of red lumps on the ears, scalp, face and trunk, in which neutrophils are also found around sweat glands.
It is recommended that affected individuals rest with their feet up.
The inflammatory reaction clears up spontaneously within 4 weeks. It may recur.
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