Juvenile Plantar Dermatosis: Readers’ Remedies

Figure – The scaling and fissures on the soles of this 10-year-old boy’s feet are the result of juvenile plantar dermatosis. Measures to help prevent rapid water loss from feet that have become sweaty in occlusive footwear often prove helpful.

In his Dermclinic case in the March 2009 issue of CONSULTANT FOR PEDIATRICIANS (page 77), Dr Kirk Barber discusses juvenile plantar dermatosis (JPD). A very simple treatment for this condition is the use of a home foot spa, in which wax is melted and the foot immersed according to the directions included with the device. Following the wax immersion procedure, the patient should apply a good lotion. JPD can be remedied or at least controlled with this treatment.

-- Patrick Sauer, MD
Billings, Mont

The Dermclinic case of a boy with JPD (Figure) interested me because I have a friend who had an adult version of this condition for years. She had fissures and involvement of the entire soles of the feet (especially the weight-bearing areas). Both her primary care physician and a dermatologist prescribed topical corticosteroids; however, these agents did not help at all. As a last resort, she soaked her feet in a warm water and vinegar bath daily for a week. Almost miraculously, her feet took on a normal appearance: the shiny skin, scaling, cracks, and painful fissures were gone. My friend has been free of this painful affliction for more than a year, even though her job as a custodian in a nursing home requires her to wear tennis shoes and to be on her feet for hours at a time.

-- Gwen Liebl, RN, PNP
Claremore, Okla

These are great ideas. The measures described support my hypothesis that this condition is related to rapid evaporation on the stratum corneum. As I pointed out in the Dermclinic case, JPD is a disorder of barrier disruption. I would add that applying an emollient between sock changes might also be beneficial.

-- Kirk Barber, MD, FRCPC
Alberta Children’s Hospital