Juvenile plantar dermatosis. A clinicopathologic study.

Fifty-six patients had juvenile plantar dermatosis (JPD). The plantar surface of the toes and the anterior third of the sole were the sites most commonly affected. Less commonly affected were the dorsal surface of the toes and the fingertips. No seasonal variation was found, and treatment was generally ineffective. Preventative measures had no influence on the course of the condition. Histopathologic features included psoriasiform acanthosis, with focal loss of granular cell layer, and uniform parakeratosis. Distinctive features included a tendency for the dermal infiltrate to localize around sweat ducts at their point of entry into the epidermis. In addition, inflammatory changes within the epidermis were localized mainly to the acrosyringium and included paranuclear vacuolization of epidermal keratinocytes, spongiosis, and slight spongiotic vesiculation. These changes are similar to those described in other eczematous conditions, and there is little evidence to suggest that disordered sweating plays a primary role in the pathogenesis of JPD.