Related Experiment Videos
[Plantar hidradenitis]
M M Brites1, O Tellechea, A P Baptista
1Serviço de Dermatologia, Hospitais da Universidade de Coimbra, Coimbra.
Insights
Idiopathic plantar hidradenitis is a rare cause of tender foot nodules in children, often mimicking other conditions. Dermatopathology confirms the diagnosis, distinguishing it from similar pediatric plantar lesions.
Area of Science:
- Dermatology
- Pediatric Pathology
- Vaccine Adverse Events
Background:
- Plantar nodules in children present diagnostic challenges due to similar morphologies across various conditions.
- Dermatopathology is crucial for definitive diagnosis of pediatric plantar lesions.
- Idiopathic plantar hidradenitis is a recently described entity.
Observation:
- A 12-year-old experienced tender, red plantar nodules post-hepatitis B vaccination.
- Clinical differential diagnoses included juvenile plantar erythema nodosum, insect bites, urticaria, and plantar hidradenitis.
- Lesions resolved spontaneously within 10 days without recurrence.
Findings:
- Skin biopsy revealed dense neutrophilic infiltrate and abscess formation around eccrine glands.
- Histopathological findings confirmed idiopathic plantar hidradenitis.
- The case highlights the importance of biopsy in diagnosing plantar hidradenitis.
Implications:
- This case expands the understanding of idiopathic plantar hidradenitis in pediatric patients.
- Accurate diagnosis is essential for appropriate management and to differentiate from other plantar conditions.
- Further research into vaccine-associated plantar hidradenitis may be warranted.
Abstract:
Tender, plantar nodules occurring in pediatric patients can be associated to different clinical entities, despite similar morphological features, therefore dermatopathology is the best technique for the definitive diagnosis. We describe the case for a 12-year-old patient with tender, red nodules on the left sole 3 days in duration, and with moderate functional disability. The onset of the lesions was preceded by low fever, and occurred 6 days after hepatitis B vaccination (Engerix B). The clinical diagnoses were juvenile plantar erythema nodosum, insect bites, pressure urticaria and plantar hidradenitis; Laboratory and radiographic studies, as well as microscopic examination of a skin biopsy specimen, were performed. The lesions resolved spontaneously in about 10 days, without recurrence after a year. A skin biopsy specimen revealed dense neutrophilic infiltrate surrounding and involving eccrine glans with abscess formation at the dermal-hypodermal junction. The diagnosis of idiopathic plantar hidradenitis was made. We discuss this entity, recently described by Stahr et al, and other erythematous plantar nodules in the pediatric age.