Atopic juvenile plantar dermatosis L20.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 04.01.2022

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atopic winter feet; Atopic winter feet; Dermatosis palmoplantaris juvenilis; Dermatosis peridigitale; Eccema e frigore; Eczema peridigitales in children; Forefoot dermatitis; Forefoot eczema; hemalic dermatitis; juvenile plantar dermatitis; juvenile plantar dermatosis; Juvenile plantar dermatosis; juvenilis plantaris dermatosis; Moon-boot foot syndrome; peridigital dermatosis; peridigital eczema in children; plantar sicca dermatitis; Prurigo hiemalis; Pseudomycosis; pulpite digital kératosique craquelée récidivante; pulpite sèche; recurrent juvenile eczema; sandbox dermatitis; sicky arthritis; Sweaty sock dermatitis; Syndrome digitocutaneum minimum; Winterfeet

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Macie, RM 1976

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Abortive manifestation of atopic eczema.

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Chronic, non-allergic, cumulatively toxic eczema reaction with mostly severe sebostasis and atopic diathesis.

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Especially occurring in children. Less common in adults.

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Mainly toe endings, also sole of the foot, heel, forefoot and fingers.

Clinical features
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Slightly inflammatory laminar redness (may also be completely absent) with uniform, broken, fine-lamellar scaling (not removable or strippable) especially in the plantar and/or palmar parts of individual or all toes and the sole parts of the forefoot (analogous description on the hands). The skin is parchment-like changed, dust-dry, provided with a delicate (atrophic) shine which becomes noticeable when viewed from the side.

Especially at the tip of the toes (also at the fingertips) painful rhagades (S.u. Pulpitis sicca) can develop, which are resistant to therapy and tend to secondary infection.

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Differential diagnosis
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Tinea pedum: acute onset, maceration, fungal detection:

Contact allergic dermatitis: history; epicutaneous testing.

Localized epidermolysis bullosa simplex (Weber-Cockayne): familiality, blistering, polysomatic genotype

Acral peeling skin syndrome: familiality, blistering, genotype - mutation in TGM5

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In case of dry parchment skin: Bland care with refatting externals such as Eucerin cum aq., Linola fat, ash base cream/ointment, Excipial almond oil ointment, Lipoderm lotion, Eucerin Omega. If necessary also with added urea (e.g. R102, Excipial U Lipolotio).

In case of firmly adhering hyperkeratoses: cream/ointments containing urea (e.g. Nubral, Basodexan), during the day 2-5% as nourishing external cream (see above). At night 5-10 min. warm soap bath (addition of liquid soap or curd soap) or oil bath (20 ml olive oil, with 10 ml milk, 5 l warm water). Immediately afterwards, apply a thick layer of cream/ointment containing 5-10% urea (e.g. Basodexan ointment, alternatively external products containing salicylic acid, e.g. Squamasol), cover with occluding household foil for 2-3 hours, fixation with cotton socks or cotton gloves.

In case of deep rhagades: Apply glucocorticoid-containing fat ointments such as 0.1% mometasone f uroate (e.g. Ecural fat ointment) in a thick layer on rhagades and surrounding area. Possibly combination of steroid/salicylic acid, e.g. Diprosalic. Apply a self-adhesive hydrocolloidal occlusive dressing (e.g. Varihesive extra thin), which is renewed daily to every 2nd day. Carry out treatment for 2-3 days. Subsequently monotherapy with hydrocolloid dressings. Avoid occluding footwear.

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Chronic course, improvement during the summer (increased sweating).

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  1. Gibbs NF (2004) Juvenile plantar dermatosis. Can sweat cause foot rash and peeling? Post Grade Med 115: 73-75
  2. Kean JR (2007) Foot problems in the adolescent. Adolesc Med State Art Rev 18:182-191
  3. Mackie RM et al (1976) Juvenile plantar dermatosis. a new entity. Clin Exp Dermatol 1: 253-260
  4. Shipley DR et al (2006) Juvenile plantar dermatosis responding to topical tacrolimus ointment. Clin Exp Dermatol 31:453-454
  5. Zagne V et al (2014) Histopathological aspects of juvenile plantar dermatosis. At J Dermatopathol 36: 359-361


Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 04.01.2022