Compression therapy in painful piezogenic pedal papules

Abstract

REPORT OF A CASE A 54-year-old woman noted soft, skin-colored, round papules on the lateral and plantar aspects of her left heel. They became progressively more painful when she was walking or standing for long intervals. Only avoidance of pressure relieved the pain and tension. Findings from a physical examination revealed several soft, round, skin-colored papules on the feet (diameter, 0.5 to 2 cm). When pressure was applied to the plantar surface, the papules became firm and tense (Figure). Magnetic resonance imaging of the most painful plantar nodule revealed a 2×1.5×1-cm capsulated fatty lesion laterocaudally to the abductor hallucis muscle. THERAPEUTIC CHALLENGE Standard treatments for painful piezogenic pedal papules include foam rubber footpads or foam-fitting plastic heel cups, avoidance of both long periods of standing and excessive trauma, and surgery. However, the anatomic structure and function of the foot are highly endangered with extensive surgery. A simple conservative treatment for