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Author: Dr Peggy Chen, Dermatology Registrar, Waikato Hospital, Hamilton, New Zealand, 2013.
Piezogenic papules are common, soft, skin-coloured papules found on the feet and wrists. They result from herniation of fat through the dermis. The name 'piezogenic' refers to the origin of the papules being pressure.
People of all ages, sexes and ethnicities are susceptible to piezogenic papules. They are commonly observed in overweight or obese women. They are also associated with underlying connective tissue diseases such as Ehlers-Danlos syndrome, flat feet, and excessive weight-bearing exercise.
Piezogenic papules are of unknown cause.
Piezogenic papules are mostly asymptomatic and are noticed incidentally. Occasionally they may be painful.
Piezogenic papules are usually diagnosed clinically because of the following features:
No treatment is required in the absence of symptoms.
For painful lesions, conservative management may include:
Intralesional corticosteroid injections have been documented to provide some relief for patients with piezogenic papules with underlying Ehlers-Danlos syndrome.
Surgical excision may be helpful if symptoms persist despite above managements but this is rarely necessary.
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