Toilet training

Juvenile Plantar Dermatosis: Readers’ Remedies

June 2, 2009


In his Dermclinic case in the March 2009 issue of CONSULTANT FOR PEDIATRICIANS (page 77), Dr Kirk Barber discusses juvenile plantar dermatosis (JPD). A very simple treatment for this condition is the use of a home foot spa, in which wax is melted and the foot immersed according to the directions included with the device. Following the wax immersion procedure, the patient should apply a good lotion. JPD can be remedied or at least controlled with this treatment.

—— Patrick Sauer, MD
Billings, Mont

The Dermclinic case of a boy with JPD (Figure) interested me because I have a friend who had an adult version of this condition for years. She had fissures and involvement of the entire soles of the feet (especially the weight-bearing areas). Both her primary care physician and a dermatologist prescribed topical corticosteroids; however, these agents did not help at all. As a last resort, she soaked her feet in a warm water and vinegar bath daily for a week. Almost miraculously, her feet took on a normal appearance: the shiny skin, scaling, cracks, and painful fissures were gone. My friend has been free of this painful affliction for more than a year, even though her job as a custodian in a nursing home requires her to wear tennis shoes and to be on her feet for hours at a time.

—— Gwen Liebl, RN, PNP
Claremore, Okla

These are great ideas. The measures described support my hypothesis that this condition is related to rapid evaporation on the stratum corneum. As I pointed out in the Dermclinic case, JPD is a disorder of barrier disruption. I would add that applying an emollient between sock changes might also be beneficial.

—— Kirk Barber, MD, FRCPC
Alberta Children’s Hospital