What is juvenile plantar dermatosis?

Juvenile plantar dermatosis is a skin condition on the soles of the feet that occurs mainly in children. It is an annoying and chronic irritation of the feet, and it almost exclusively affects children. Other names for this condition include "atopic winter feet," "forefoot eczema," or "dermatitis plantaris sicca." It is most common in children who are predisposed to allergies, such as those with eczema, hay fever, asthma, or food allergies. The peak age of onset is between 4 and 7 years, and it rarely occurs in children younger than 1 year of age.

How does juvenile plantar dermatosis develop?

Juvenile plantar dermatosis is seen as a localized, chronic irritation reaction on the feet. Most patients have atopic eczema or sensitive, dry skin. Some contributing factors include wearing (too) tight-fitting synthetic shoes, such as rubber boots in the winter months, and using non-absorbent socks, such as socks made of polyester or nylon. This leads to excessive sweating. Sometimes patients also experience symptoms at the fingertips, presumably from wearing occlusive gloves or mittens. In short, constant wetting and drying of sensitive skin areas leads to a chronic irritation reaction.

What does juvenile plantar dermatosis look like?

Symptoms are especially noticeable during the winter months. There is an almost completely symmetrical skin defect on parts of the feet that come in contact with the shoes, such as the ball of the feet, the tips of the toes, and the heels, while the instep is spared. The affected skin is dry, red, and scaly. Later, the skin becomes thin, leading to easy development of (painful) fissures. Walking can also be painful. The first abnormalities usually occur on the big toe, and sometimes the fingertips are also affected.

How is juvenile plantar dermatosis diagnosed?

In most cases, the diagnosis is made visually. Sometimes it can resemble a foot fungus, although in the latter the redness and scaling are never as symmetrical. To rule out a contact allergy to shoes, an allergy test can sometimes be performed, called "sticky tests."

What is the treatment for juvenile plantar dermatosis?

It is important to keep feet constantly greasy. The feet should be greased in the morning before school, and as soon as the socks come off when you get home, the feet should be greased again to prevent sweaty feet from drying out. Usually the dermatologist also prescribes ointments that contain a horny solvent, such as urea or salicylic acid. The use of perfumed or perubaline-containing ointments should be avoided. In cases of exacerbation, a corticosteroid cream may be prescribed. In severe cases, with extensive and painful fissures, complete bed rest is recommended, which usually results in almost complete recovery within a few days.

What can you do yourself about juvenile plantar dermatosis?

It is advisable to keep feet as oily as possible and avoid excessive sweating. Do not wear occlusive shoes, such as rubber boots, and synthetic socks during the winter period. To absorb sweat better, two pairs of cotton socks can be worn on top of each other. During the summer months, it is good to wear shoes that allow the feet to breathe well.

Does juvenile plantar dermatosis go away on its own?

Yes, juvenile plantar dermatosis disappears spontaneously at the onset of adolescence. The condition has a chronic course, with exacerbations during the winter months usually lasting 1 to 2 weeks and occurring once a year, but sometimes 5 to 10 times. Excessive sweating and the use of synthetic footwear are then often cited as triggering factors.

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