Juvenile plantar dermatosis versus pitted



Juvenile plantar dermatosis
Clinical features

  • Occurs in children, usually between the ages of seven and 14.
  • Affects the soles of the feet.
  • Shiny, glazed appearance.
  • Skin becomes cracked and scaly.
  • Children complain of painful, itching fissures.
  • Toe webs not usually affected.

Management

  • Avoidance of occlusive socks and shoes. Cotton socks and leather shoes or open sandals to be encouraged.
  • Liberal application of emollients such as white soft paraffin.
  • Occlusion of fissures helps healing. Cover with plasters or apply liquid bandage or nail glue.
  • Topical steroids are not recommended.
  • Expect gradual improvement as the child gets older.

Pitted keratolysis
Presentation

  • Small, punched-out erosions on the soles of both feet.
  • Bacterial infection that may occur at any age.
  • Feet so malodorous they may be socially embarrassing.
  • Feet are sweaty and may feel slimy.
  • The instep is rarely affected.
  • Occasionally affects the palms of the hand.
  • May be symptomless, but occasionally sore and itchy.

Management

  • A clinical diagnosis can usually be made based on the odour and appearance of the feet.
  • Avoid occlusive footwear; use absorbent cotton socks.
  • Apply an antiperspirant, such as 20 per cent aluminium chloride solution, twice a week.
  • Topical antibiotics (erythromycin or clindamycin solution) twice a day should clear the infection in three to four weeks.
  • Oral erythromycin for resistant or persistent cases.
Dr Jean Watkins, a GP locum in Hampshire

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

BMA House entrance

GPs face pension tax penalties worth 'half their post-tax income'

Rapid swings in inflation could leave GPs facing pension tax penalties worth 'half...

Sign outside BMA House

BMA to demand significant pay rises to combat 15 years of real-term cuts

The BMA is set to demand significant pay rises for all doctors to undo over a decade...

UK police station

Reporting a crime in the practice – the confidentiality dilemma

With incidents of aggressive behaviour from patients on the rise, Dr Emma Green,...

Sign reading 'General Medical Council'

GMC backs reversal of GP suspension over laptop and admits tribunal error

The GMC has admitted a medical tribunal was wrong to suspend a Manchester GP for...

Dr Chaand Nagpaul

Government 'willfully shrinking workforce' and exploiting doctors' goodwill, warns Nagpaul

The government is exploiting doctors' goodwill while persistently failing to adopt...

Vaccination tracker

UK COVID-19 vaccination programme tracker

GPs across the UK have led the largest-ever NHS vaccination programme in response...