Plantar Fibromatosis—Topical Review

Abstract

Morbus Ledderhose is a rare hyperproliferative disease of the plantar fascia, leading to the formation of nodules. Its origin is unknown. No causal therapy is available, and treatment remains symptomatic. Various therapeutic strategies to alleviate symptoms are available and are adapted to the severity of the disease. In early stages, conservative therapy including nonpharmacological, physical, and pharmacological treatments is applied. If the disease progresses, irradiation of the plantar surface, injections of steroids, shock wave therapy, and partial or complete fasciectomy as an ultimate therapy may be indicated. Novel experimental treatment options including application of fibrinolytic agents are currently being tested, but no controlled, randomized long-term studies are available. This review aims to provide a systematic overview of current established procedures and outlines novel experimental strategies for the treatment of morbus Ledderhose, including future avenues to treat this rare disease.

Eponyms in dermatology literature linked to fifi bromatoses

“…Ledderhose's disease [1,6,7] Also known as Plantar fi bromatosis or Morbus Ledderhose. It is a fi brous proliferation arising within the plantar fascia end exhibits typical clinical nodular features.…”

Plantar Fibromatosis: An Unusual Cause of Plantar Pain

“…Surgery should relieve pain as well as maintain the patient's ability to walk. Local excision, wide excision, and complete fasciectomy are possible operative methods, however the recurrences rates are high [5]. …”

“…Conservative treatment includes anti-inflammatory drugs, intralesional corticosteroid injections, physical therapy, and orthopedic insoles. Radiotherapy and extracorporeal shock wave therapy are also being used [5]. The surgical options are chosen when conservative measures fail to improve symptoms and prevent the progression of the disease.…”

Endoscopic Subtotal Fasciectomy of the Foot

“…[4][5][6] No causal therapy is available, and treatment remains symptomatic. 7 Nonsurgical treatment is the first line of treatment to reduce the progression of symptoms and includes intralesional cortisone or collagenase injections, stretching exercise, custom-molded orthotics, antiinflammatory drugs, physical therapy, shockwave therapy, and radiotherapy. [1][2][3]7,8 These modalities frequently do not halt the tumor progression, but they may decrease the patient's symptoms to a tolerable level.…”

“…7 Nonsurgical treatment is the first line of treatment to reduce the progression of symptoms and includes intralesional cortisone or collagenase injections, stretching exercise, custom-molded orthotics, antiinflammatory drugs, physical therapy, shockwave therapy, and radiotherapy. [1][2][3]7,8 These modalities frequently do not halt the tumor progression, but they may decrease the patient's symptoms to a tolerable level. 2 Because of the high recurrence rate associated with surgical treatment, operation is indicated only when the lesions are highly symptomatic and conservative measures fail or the diagnosis is in question.…”