J Am Podiatr Med Assoc 2018 Mar;108(2):178-181

Acrokeratoelastoidosis (AKE) is a rare form of focal acral keratoderma of unknown cause that typically begins during childhood and manifests with multiple, small, hyperkeratotic papules located over the lateral margins of the hands and feet. The purpose of this article is to report a pediatric case of AKE with dermoscopic, sonographic, and histopathologic descriptions, contributing to the awareness of this clinical diagnosis. We describe a 7-year-old girl with nonpainful yellowish papules on the lateral and medial aspects of both feet. Read More

Am J Dermatopathol 2018 Mar 21. Epub 2018 Mar 21.

Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

J Dermatol 2017 Dec 15;44(12):e361-e362. Epub 2017 Aug 15.

Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Indian J Dermatol 2016 Mar-Apr;61(2):234

Department of Cardiology, Faculty of Medicine, University of Baskent, Ankara, Turkey.

Piezogenic pedal papules (PPP) are herniations of subcutaneous adipose tissue into the dermis. PPP are skin-colored to yellowish papules and nodules on lateral surfaces of feet that typically become apparent when the patient stands flat on his/her feet. Some connective tissue diseases and syndromes have been reported in association with PPP. Read More

An Bras Dermatol 2015 Nov-Dec;90(6):928-9

Universidade Federal da Bahia, Salvador, BA, Brazil.

Actas Dermosifiliogr 2015 Sep 20;106(7):591-3. Epub 2015 Feb 20.

Servicio de Dermatología, Hospital Universitario La Paz, Madrid, España.

Indian Dermatol Online J 2013 Oct;4(4):369-71

Department of Pathology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey.

J Pediatr 2013 Dec 5;163(6):1788. Epub 2013 Sep 5.

Departments of Dermatology, Venereology, and Allergology, University Hospital Würzburg, Würzburg, Germany.

Acta Dermatovenerol Croat 2013 ;21(2):118-22

Department of Dermatology and Venereology, Hospital São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal.

Easy bruising in children represents a diagnostic conundrum. Although trauma (accidental or not) and bleeding disturbances are the most common causes, other rarer etiologies should be considered in differential diagnosis. When a 4-year-old male patient presented with a history of bruising and hematomas after slight injuries, coagulopathy and physical abuse were suspected. Read More

CMAJ 2013 Dec 24;185(18):E847. Epub 2013 Jun 24.

Am J Dermatopathol 2012 Dec;34(8):e111-3

Department of Dermatology, The Armed Forces Hongcheon Hospital, Hongcheon, Korea.

Piezogenic papules are lesions that occur on the feet and wrists because of the herniation of fat through the dermis. These papules can be painful or completely asymptomatic. Poor compartmentalization of fat occurs because of thinner than normal fibrous trabeculae and contributes to the formation of piezogenic papules. Read More

Sports Med 2011 Sep;41(9):709-19

Department of Dermatology, Columbia University Medical Center, New York, NY 10032, USA.

Figure skaters, ice-hockey players and speed skaters experience a range of dermatologic conditions and tissue-related injuries on account of mechanical trauma, infectious pathogens, inflammatory processes and environmental factors related to these competitive pursuits. Sports medicine practitioners, family physicians, dermatologists and coaches should be familiar with these skin conditions to ensure timely and accurate diagnosis and management of affected athletes. This review is Part I of a subsequent companion review and provides a comprehensive review of mechanical dermatoses experienced by ice-skating athletes, including skater's nodules and its variants, pump bumps, piezogenic pedal papules, talon noir, skate/lace bite, friction bullae, corns and calluses, onychocryptosis, skater's toe and skate blade-induced lacerations. Read More

Ned Tijdschr Geneeskd 2011 ;155(29):A2576

Slotervaartziekenhuis, afd. Dermatologie, Amsterdam, the Netherlands.

A 57-year-old woman came to the dermatologist because of 'strange bumps' on her feet. The bumps were not painful. On physical examination bumps were seen on the medial parts of her left foot, near the sole. Read More

J Dtsch Dermatol Ges 2010 Jun;8(6):474

J Dtsch Dermatol Ges 2010 Jan;8(1):61-2

Klinik für Dermatologie, Venerologie und Allergologie, Universität Leipzig A.ö.R., Leipzig.

Clin Exp Dermatol 2009 Oct 18;34(7):e325-6. Epub 2009 May 18.

Ned Tijdschr Geneeskd 2008 Jul;152(28):1570

Meander Medisch Centrum, locatie Elisabeth, afd. Dermatologie, Amersfoort.

A 54-year-old woman had piezogenic pedal papules. They became apparent when she was standing, and disappeared when the weight was taken off the foot. Read More

JAAPA 2007 Jul;20(7):15

University of Oklahoma, Physician Assistant Program, Oklahoma City, USA.

Indian J Dermatol Venereol Leprol 2002 Mar-Apr;68(2):107-8

Department of Dermatology, J.N. Medical College, A.M.U., Aligarh, India.

A 14-year-old female with rheumatic heart disease presented with multiple painless, non-itchy papules on her heel. Painless papules consisted of normal fat tissues. Read More

Clin J Sport Med 2006 Jan;16(1):81-3

Department of Dermatology, University of Cincinnati, University Hospital, Cincinnati, OH 45267, USA.

J Eur Acad Dermatol Venereol 2005 Jan;19(1):136-7

Cutis 2004 May;73(5):339-40, 346

Department of Family Practice and Community Medicine, University of Pennsylvania, Philadelphia 19104-4283, USA.

For more than 3 decades, piezogenic pedal papules have been described in the literature. While many individuals with these papules are asymptomatic, patients with trauma or connective tissue diseases can experience pain. In our case study, we describe a unique, nonsurgical approach that abates the pain of painful piezogenic pedal papule (PPPP). Read More

Skinmed 2003 Jan-Feb;2(1):34-40

The Department of Dermatology, Tulane University School of Medicine, 1430 Tulane Avenue TB36, New Orleans, LA 70112, USA.

Various means of skin injury in athletes are examined, supplementing those discussed in Cutaneous Manifestations of Disease Part 1 (November/ December). Skin injury due to mechanical means such as corns, calluses, talon noir (calcaneal petechiae), tennis toe, joggers nipples, and piezogenic pedal papules will be discussed followed by a thorough discussion of environmental means of skin injury. There are a variety of ways that the environment may affect athletes both during competition and years after the competition is finished. Read More

Br J Dermatol 1997 Apr;136(4):628-30

Dermatology Department, West Suffolk Hospital, Bury St Edmunds, Suffolk, U.K.

We report the case of a woman who had pain in both heels which was exacerbated by long periods of exercise. On examination, there were small flesh-coloured papules which appeared over the medial and lateral aspects of the heels only on weight bearing. Coincidentally, she was noted to have larger flesh-coloured papules over the anterior surface of the shins. Read More

Cutis 1996 Apr;57(4):260-2

Division of Dermatology, Saint Louis University Health Sciences Center, Missouri, USA.

Piezogenic pedal papules are small, occasionally painful, fat herniations that become apparent when weight is placed on the heel. Although the cause is unknown, hereditary factors may play a role. This is the second report of two family members with this condition. Read More

Arch Dermatol 1996 Feb;132(2):127-8

University Hospital of Zurich, Switzerland.

J Pak Med Assoc 1995 Apr;45(4):93-4

Department of Dermatology, Jinnah Postgraduate Medical Centre, Karachi.

Hundred people were examined for piezogenic papules (cutaneous hernia). Of these 80 had pedal papules, 86 wrist papules and 74 both pedal and wrist papules. Most of these papules were bilateral and multiple. Read More

Pediatr Dermatol 1991 Dec;8(4):277-9

Department of Pediatrics, Academic Medical Centre, Amsterdam, The Netherlands.

Piezogenic papules (PP) are pressure-induced lesions that appear on the heels while bearing weight, due to herniation of fat tissue into the dermis. They are present in the majority of adults. Because of the poor quality of connective tissue in hereditary disorders of connective tissue, such as the Ehlers-Danlos syndrome, it has been suggested that PP would be larger in number and diameter in this group of disorders. Read More

J Am Acad Dermatol 1991 Mar;24(3):415-7

Department of Dermatology, University of North Carolina Hospitals, Chapel Hill 27514.

The first description of piezogenic wrist papules is presented. Twenty-nine persons were examined; 76% had pedal papules and 86% had wrist papules. Piezogenic papules are a common, nonhereditary finding and are not secondary to an inherent connective tissue defect. Read More

J Am Podiatr Med Assoc 1990 Aug;80(8):444-5

Department of Medicine, Pennsylvania College of Podiatric Medicine, Philadelphia.

A unique presentation of a painful piezogenic papule in the medial longitudinal arch has been presented. This lesion puts pressure on nearby structures, causing pain. Walking without pain is achieved through orthopedic padding. Read More

Med Cutan Ibero Lat Am 1990 ;18(1):9-12

Hospital Posadas de Haedo (provincia de Buenos Aires), Argentina.

Four cases of newborn children who presented pedal papules since birth, are reported. They showed the following features, different from the ones seen in adults: a solitary lesion, bigger size, localization on medial plantar region aspect of the heel, presence at birth, absence of an obvious piezogenic factor, physiopathogenic model that explains the development of lesions in adults, which are compared to those appearing in the newborn, are proposed. Read More

Med Cutan Ibero Lat Am 1989 ;17(6):399-401

Facultad de Medicina, Universidad de Buenos Aires, Argentina.

We make a brief bibliographic revision of the entity. We observe three cases with piezogenic pedal nodules, wrongly named painful piezogenic pedal papules; as they not always have that localization and symptomatology. An easy treatment is proposed, with an effective result to calm the pain when it appears. Read More

J Am Acad Dermatol 1987 Aug;17(2 Pt 1):205-9

Painful piezogenic pedal papules were observed in 10 of 29 patients with Ehlers-Danlos syndrome. The diagnosis was made by examining each patient while he or she stood with full body weight on the heels and by observing the appearance of the painful papules on the medial, posterior, and lateral aspects of both heels. Biopsy specimens of papules demonstrated a thickened and dense dermis. Read More

Schweiz Med Wochenschr 1986 Aug;116(35):1189-94

Reports on skin problems in joggers are rare in medical literature. Jogger dermatoses are caused by repeated trauma, mechanic overuse, thermic effects, allergic-toxic reactions and infectious processes. Most common are bullosis mechanica, piezogenic papules, hyperkeratosis haemorrhagica and subungual haematomas. Read More

Derm Beruf Umwelt 1986 Jul-Aug;34(4):106-7

Piezogenic papules are present in 10%-20% of the investigated population. They occur in all age groups, more frequently among women than men, but also among children, as shown in this case report. Herniation of fat tissue into the dermis causes their appearance. Read More

Pediatr Dermatol 1985 Nov;3(1):45-7

A 5-year-old girl with Ehlers-Danlos syndrome developed painful piezogenic pedal papules. She had suffered from pain in her heels for the previous two years and had undergone extensive orthopedic examinations that revealed no abnormalities. On admission, she had typical signs associated with piezogenic pedal papules (PPP), with pain induced by standing and disappearance of the lesions and the pain on relief of pressure. Read More

J Bone Joint Surg Am 1985 Apr;67(4):640-1

Ann Dermatol Venereol 1985 ;112(2):181-2

Cutis 1984 Jul;34(1):70

Ann Dermatol Venereol 1984 ;111(6-7):575

Ann Dermatol Venereol 1984 ;111(6-7):574

Ann Dermatol Venereol 1984 ;111(6-7):571-3

Cutis 1982 Mar;29(3):276-7, 280

J Am Acad Dermatol 1980 Oct;3(4):415-24

The skin lies at the interface of the athlete and the sports milieu and is subjected to many sports-related dermatoses. Direct traumatic injuries, such as friction blisters, black heel, piezogenic papules, and traumatic subungual hematomas, occur regularly. Environmental insults such as sunburn, cold-induced injury, and contact dermatitis plague the sportsman. Read More

J Am Podiatry Assoc 1978 Oct;68(10):703-5

Beitr Orthop Traumatol 1977 Apr;24(4):226-8

J Am Podiatry Assoc 1977 Feb;67(2):120-1

Dermatol Monatsschr 1975 Jan;161(1):43-5

Br J Dermatol 1975 Jan;92(1):113