(BMJ)—A 9-yo boy presented w/ painful lesions on the soles of both feet, which had erupted the day before, after prolonged walking w/ rubber boots. Exam: multiple, reddish to purple, nonconfluent nodules. CBC, ESR, ANA: normal. What is the diagnosis?
Juvenile plantar dermatosis
Plantar fasciitis
Erythema nodosum
Traumatic plantar urticaria
Palmoplantar eccrine hidradenitis
You are correct. Histologic exam revealed a dense neutrophilic infiltrate of the eccrine cells consistent w/ palmoplantar eccrine hidradenitis. PEH is an uncommon dz, characterized by erythematous violaceous papules and nodules of abrupt onset on the soles of otherwise healthy children; palms may rarely be involved. The nodules usually appear after intense physical activity and are so painful that they lead to walking impairment. PEH has a self-limiting course; abstention from physical activity and bed rest alone are the best tx, leading to complete regression of lesions in about a week.