RECURRENT PALMOPLANTAR HIDRADENITIS IN CHILDREN

By Gary M. White, MD


Recurrent Palmoplantar Hidradenitis In Children (RPHC) is a benign, self-limiting disease of young, healthy children that probably results from inflammation due to mechanical or thermal trauma resulting in rupture of palmoplantar eccrine glands. 

Clinical

Recurrent episodes of tender, erythematous, inflammatory nodules on the palms and soles is characteristic. Involvement of both soles or only one sole may occur. Low grade fever may be associated.

Individual episodes usually resolve within 12 days. In two children, use of cotton tights with a GORE-TEX membrane while wearing boots during cold weather was associated with recurrent palmoplantar hidradenitis. Stopping the use of the cotton tights cured the patients.

Differential Diagnosis

The differential diagnosis includes infection from Pseudomonas and mycobacterium abscessus. Pseudomonas infection is more likely if there is a history of recent hot tub use or even coexistent hot tub folliculitis. Mycobacterium abscessus infection occurs about 2 months after swimming in a contaminated pool.

Treatment

Regression is usually rapid, with complete clearing after one month.  Recurrences may occur.

References

An 11-year-old boy presented with a 1-day history of swelling and severely painful erythematous to violaceous nodules on the soles of both feet, which were limiting his ability to walk. The lesions were accompanied by low-grade fever (38°C) but no other systemic signs or symptoms. [Can Fam Physician. 2010 Jul; 56(7): 666].

JAAD November 2002 Volume 47, Issue 5, Supplement, Pages S263–S265

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