Painful piezogenic pedal papules in patients with Ehlers-Danlos syndrome

https://doi.org/10.1016/S0190-9622(87)70192-3Get rights and content

Abstract

Painful piezogenic pedal papules were observed in 10 of 29 patients with Ehlers-Danlos syndrome. The diagnosis was made by examining each patient while he or she stood with full body weight on the heels and by observing the appearance of the painful papules on the medial, posterior, and lateral aspects of both heels. Biopsy specimens of papules demonstrated a thickened and dense dermis. The subcutaneous fibrous trabeculae were thin, with resultant poor compartmentalization of the fat. Painful piezogenic pedal papules are due to herniation of subcutaneous fat into the dermis, which is possibly due to structural defects of the connective tissue. The high prevalence of painful piezogenic pedal papules in our group of patients (34.5%) makes its direct association with the Ehlers-Danlos syndrome highly feasible, most probably because of the connective tissue defect that occurs in patients with Ehlers-Danlos syndrome.

References (14)

  • J Uitto et al.

    Defects in the biochemistry of collagen in diseases of connective tissue

    J Invest Dermatol

    (1976)
  • WB Shelly et al.

    Painful feet due to herniation of fat

    JAMA

    (1968)
  • OLA Schlappner et al.

    Painful and non-painful piezogenic pedal papules

    Arch Dermatol

    (1972)
  • RRM Harman et al.

    Painful pedal piezogenic papules

    Br J Dermatol

    (1974)
  • DJ Grant

    Piezogenic pedal papules [Letter]

    Arch Dermatol

    (1970)
  • M Kahana et al.

    Painful piezogenic pedal papules on a child with Ehlers-Danlos syndrome

    Pediatr Dermatol

    (1985)
  • PH Byers et al.

    Ehlers-Danlos syndrome

There are more references available in the full text version of this article.

Cited by (0)

*

From the Department of Dermatology and the Institute of Pathology, the Chaim Sheba Medical Center, Tel-Hashomer, Jerusalem.

***

Sackler School of Medicine, Tel-Aviv University, Jerusalem.

**

the Department of Pediatrics, Kaplan Hospital, Rehovot, Jerusalem.

****

Hadassah School of Medicine, The Hebrew University, Jerusalem.

View full text