Juvenile plantar dermatosis

Author: Original page by Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1997. Updated by Dr Anita Eshraghi, Dermatologist, Sweden, and Dr Oakley, in March 2018.  


What is juvenile plantar dermatosis?

Juvenile plantar dermatosis is a common and chronic, dry-skin condition of the feet that affects children. Occasionally the hands develop similar signs. There is seasonal variation.

Juvenile plantar dermatosis is also known as atopic winter feet, forefoot dermatitis, dermatitis plantaris sicca, moon-boot foot syndrome, and sweaty sock dermatitis.

Juvenile plantar dermatosis

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Who gets juvenile plantar dermatosis?

Juvenile plantar dermatosis commonly affects children between the age of 3 and 14 years, with an average age of 8. It occurs slightly more frequent in boys than girls. Juvenile plantar dermatosis is rarely seen in adults because of thicker plantar skin.

Patients with atopic dermatitis, asthma or hay fever have a higher risk of developing juvenile plantar dermatosis than others. 

What causes juvenile plantar dermatosis?

Juvenile plantar dermatosis is caused by:

  • Repetitive frictional movements, as the foot moves up and down in a shoe
  • The occlusive effect of covered footwear, especially synthetic shoes (eg, nylon or vinyl)
  • Excessive sweating (hyperhidrosis), which when followed by rapid drying leads to cracking and fissuring
  • Genetic sensitivity of the skin 
  • Climatic changes: with worsening during the summer months due to heat and sweating, and in colder months due to the wearing of winter boots.

What are the clinical features of juvenile plantar dermatosis

Juvenile plantar dermatosis presents with shiny, red and dry skin on the weight-bearing areas of the sole of the feet.

  • It usually affects both feet symmetrically.
  • Painful fissures, cracking and scaling occur when juvenile plantar dermatosis is longstanding.
  • Common sites are the plantar aspect of the great toe, forefoot and heel;  toe-webs and instep are often spared.
  • It can rarely affect the palms and fingertips.

What are the complications of juvenile plantar dermatosis?

  • The most common complication of juvenile plantar dermatosis is painful cracks and fissures. These may take many weeks or months to heal.

How is juvenile plantar dermatosis diagnosed?

The diagnosis of juvenile plantar dermatosis is based on the clinical findings and a typical history of excessive sweating of the feet.

Skin scrapings to exclude a fungal infection (tinea pedis) and patch tests to exclude contact allergy to footwear may be performed.

What is the differential diagnosis for juvenile plantar dermatosis?

Juvenile plantar dermatosis is sometimes difficult to distinguish from:

What is the treatment for juvenile plantar dermatosis

Reduce friction

  • Wear well fitting shoes, preferably leather, to avoid as much friction as possible.
  • Wearing two or more pairs of cotton or woollen socks can also help reduce friction.
  • Avoid wearing shoes and socks made of synthetic materials.
  • Change socks regularly.

Lubricate the dry skin

  • Apply moisturising cream containing urea or petrolatum, after bath and before bed.
  • Barrier cream (containing dimeticone) are easier to wear during the day and should be applied every 4 hours.

Have a rest daily

  • Schedule quiet times with little or no walking to allow fissures to heal.

Cover cracks

  • Fissures heal faster when occluded. Adhesive plasters are usually satisfactory.
  • Spray or liquid acrylate glue can be applied to the fissures to relieve pain.

Prescription ointments

What is the outcome for juvenile plantar dermatosis?

The prognosis for juvenile plantar dermatosis is good. It usually clears around puberty.

 

 

Related Information

References

  • Shipley DR, Kennedy CT. Juvenile plantar dermatosis responding to topical tacrolimus ointment. Clin Exp Dermatol. 2006 May;31(3):453-4. Review. PubMed PMID: 16681600. PubMed.
  • Ashton RE, Griffiths WA. Juvenile Plantar Dermatosis--atopy or footwear? Clin Exp Dermatol. 1986 Nov;11(6):529-34. PubMed PMID: 3665141. PubMed.
  • Ashton RE, Jones RR, Griffiths A. Juvenile plantar dermatosis. A clinicopathologic study. Arch Dermatol. 1985 Feb;121(2):225-8. PubMed PMID:3977336. PubMed.
  • Harding CR. The stratum corneum: Structure and function in health and disease. Dermatol Ther 2004;17 Suppl 1:6-15. PubMed.
  • Elias PM, Choi EH. Interactions among stratum corneum defensive functions. Exp Dermatol. 2005 Oct;14(10):719-26. Review. PubMed PMID: 16176279. PubMed.

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