Mom brings her 8-year-old boy in with this--a shiny, peeling distal sole.

JUVENILE PLANTAR DERMATOSIS

Juvenile plantar dermatosis (JPD), also known as “wet and dry foot syndrome,” is a dermatitis of the soles of the feet that most commonly affects boys from 3–14 years of age. The distal 1/3 of the sole and toes is usually shiny and peeling. Patients often have atopic dermatitis, but not always.

• Tinea pedis and shoe dermatitis should be excluded.
• The distal 1/3 of the dorsal foot is preferred, and especially the toes.
  
• Fissures are not uncommon.
• A percentage of patients have postive patch testing. The most common in one study were rubber and potassium dichromate.

Treatment, Brief Overview

• Reduce friction
• Wear only well-fitting shoes, preferable with cotton socks.
• Moisturize the skin after the bath and 12 hours later with an ointment, e.g. Vaseline, Aquaphor.
• For any fissures, use Krazy glue or cover with a topical antibiotic and a bandage.
• Topical steroids, e.g. triamcinolone, mometasone, or tacrolimus may be tried BID for 2 weeks.
  
• It will be interesting to see if the newer agents, e.g. tapinaroff, ruxolitinib or roflumilast will be effective.

Therapy often meets with only partial success.

RegionalDerm

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