Idiopathic plantar hidradenitis

Author: Dr Mark Duffill, Dermatologist, Hamilton, New Zealand, 2008.

What is idiopathic plantar hidradenitis?

Idiopathic plantar hidradenitis is an uncommon condition affecting children where tender, red lumps appear on the soles and palms. It has also been called palmoplantar eccrine hidradenitis.

Idiopathic plantar hidradenitis should be distinguished from a similar condition affecting adults, called neutrophilic eccrine hidradenitis, which may arise in patients with acute myelogenous leukaemia when treated by chemotherapy.

What are the symptoms of idiopathic plantar hidradenitis?

The lumps make walking uncomfortable. The children are otherwise healthy.

Idiopathic plantar hidradenitis clears up spontaneously within 4 weeks. However, it may recur.

What is the cause of idiopathic plantar hidradenitis?

Skin biopsies of idiopathic plantar hidradenitis have shown that the sweat glands are surrounded by neutrophils. Neutrophils are white blood cells that are characteristically found in acute inflammation. Possibly they appear in response to blocked sweat ducts.

The cause of the inflammation is generally unknown but exercise, excessive sweating and prolonged wetness are possible factors. There is a tendency for the condition to appear in the spring and autumn.

Investigations

In typical cases no investigations are needed. In less typical cases a skin biopsy may be done.

Management

It is recommended that affected children rest with their feet up. Mild analgesics such as paracetamol may be taken if needed.

Colchicine has been reported to be effective.

Related information

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