Grange F, Couilliet D, Krzisch S, Grosshans E, Guillaume J C
Service de Dermatologie, Hôpital Pasteur, Colmar.
Ann Dermatol Venereol. 1996;123(2):109-13.
Plantar hidradenitis, one of several possible causes of painful papulo-nodular lesions of the foot in children and young adults, was recently described as the presence of characteristic lesions of the eccrine sweat glands.
A 15-year-old boy consulted for a sudden-onset painful eruption on the sole of the right foot. Physical examination revealed papulo-nodular erythromato-violet infiltrated lesions located on the anterior part of the right planta. Histology examination showed dense neutrophil inflammatory infiltration predominating at the dermo-hypodermic junction around the eccrine sweat glands. The excretory ducts of the sweat glands were infiltrated but the secretory glomerulae were intact. A dense infiltration of venular thrombi without vasculitis was also seen. The lesion regressed with aspirin (8 days) and rest. No recurrence has been recorded after 18 months.
This clinical and histological presentation led to the diagnosis of plantar hidradenitis, confirming the disease entity. Former cases may have been described as trauma-induced plantar urticaria or plantar erythema nodosum. This diagnosis should be entertained in children or young adults with painful papulo-nodular eruptions of the soles. The histology examination should include the eccrine sweat glands.
足底汗腺炎是儿童和青年足部疼痛性丘疹结节性病变的几种可能病因之一,最近被描述为存在特征性的小汗腺病变。
一名15岁男孩因右脚掌突然出现疼痛性皮疹前来就诊。体格检查发现右足底前部有丘疹结节性红紫色浸润性病变。组织学检查显示,密集的中性粒细胞炎性浸润主要位于小汗腺周围的真皮-皮下组织交界处。汗腺的排泄管有浸润,但分泌小球完整。还可见密集的静脉血栓浸润,无血管炎。病变在使用阿司匹林(8天)并休息后消退。18个月后未记录到复发情况。
这种临床和组织学表现导致了足底汗腺炎的诊断,证实了该疾病实体。以前的病例可能被描述为创伤性足底荨麻疹或足底结节性红斑。对于有足底疼痛性丘疹结节性皮疹的儿童或青年,应考虑这一诊断。组织学检查应包括小汗腺。