[Plantar fibromatosis with marked cutaneous involvement]

Area of Science:

• Dermatology
• Pathology

Background:

• Plantar fibromatosis typically presents as palpable nodules in the plantar arch.
• Cutaneous involvement, particularly ulceration, is an uncommon manifestation.

Observation:

• A 55-year-old male presented with a 3-year history of painful plantar nodules and ulceration.
• Histopathology revealed fibroblastic proliferation with pseudosarcomatous features.

Findings:

• Immunohistochemistry confirmed myofibroblast markers (vimentin, alpha-actin, desmin).
• Intralesional corticosteroid therapy was ineffective in reducing the lesions.
• Surgical excision resulted in recurrence of the plantar fibromatosis.

Implications:

• This case highlights the rare cutaneous presentation of plantar fibromatosis.
• The pseudosarcomatous nature and myofibroblast markers warrant careful histopathological evaluation.
• Recurrence after surgery suggests the need for further investigation into optimal management strategies for extensive or ulcerative plantar fibromatosis.