Plantar hidradenitis in children induced by exposure to wet footwear

Abstract

Painful erythematous papules and nodules involving either the palms of the hands, or, more commonly, the soles of the feet, characterize palmoplantar eccrine hidradenitis or palmoplantar hidradenitis (PH). The younger pediatric population is predominately affected. Histologically, the eccrine gland apparatus is the target of inflammatory neutrophilic infiltrates. This entity has been reported under a variety of names, including traumatic plantar urticaria, neutrophilic eccrine hidradenitis, plantar erythema nodosum, and idiopathic recurrent palmoplantar hidradenitis. All are essentially the same process, described in different forms. Despite the growing number of reported cases, the pathogenesis remains obscure. We present four children with PH of the soles of the feet, who shared a common recent history of exposure to cold, damp, footwear. The temporal relationship between exposure to dampness and cold and the appearance of the skin lesions suggest a possible pathogenetic mechanism.

Therapy-Resistant, Spontaneously Remitting Generalized Neutrophilic Eccrine Hidradenitis in a Healthy Patient Decreases the Expression of Dermcidin in Affected Eccrine Glands

“…The first one postulates that NEH is the consequence of a direct cytotoxicity of a drug secreted in the sweat in eccrine coils and duct cells, while the other one suggests that NEH is one from the spectrum of neutrophilic dermatoses, as are Sweet's syndrome and hematological malignancies [2]. Association with temporal intense physical activity and exposure to cold has been reported [13]. The onset is often associated with fever [14].…”

The Pseudomonas Hot-Foot Syndrome

“…This is an uncommonly reported condition, and our search of the English-language literature found 47 cases. [4][5][6][7][8][9][10][11][12] The pathogenesis is unknown, but traumainduced rupture of the eccrine glands 6,8 and exposure to wet occlusive footwear 9,10 have been implicated. As was true of our patients' illness, idiopathic palmoplantar hidradenitis is characterized by self-limited, tender, erythematous plaques and nodules on the soles of young children.…”

Neutrophilic Dermatoses in Children

“…Children with idiopathic palmoplantar hidradenitis develop tender erythematous plaques and nodules on the palms or, less commonly, the soles with acute onset, often after cold exposure, local trauma, physical activity, or prolonged wetness ⁄ sweating (68)(69)(70)(71)(72)(73)(74)(75)(76). No associated medication or underlying disease can be identified and patients are afebrile.…”

“…In a minority of patients, lesions recur. Younger children may be predisposed because of the immaturity of their eccrine glands (68)(69)(70)(71)(72)(73)(74)(75)(76). Several series described seasonality to cases, with peaks in the spring, summer, or autumn.…”