Juvenile Palmar-Plantar Dermatosis
Juvenile palmar-plantar dermatosis, also known as sweaty-sock syndrome, is a disorder commonly seen in toddlers and school-age children. It consists of chronic symmetric, scaly, erythema (redness or rash) with cracking and fissuring on the toes and soles of feet. Fissuring may become quite extensive and can cause considerable discomfort. The condition is thought to be due to overall moisture loss.
Treatment consists of using cotton socks, thick emollients as barrier agents and medium-strength topical corticosteroids. The disorder is thought to be exacerbated by excessive sweating and occlusive footwear (tight, non-breathable shoes), so it tends to subside in the summer months.
Juvenile palmar-plantar dermatosis generally remits by puberty. The disorder is often worse in patients with atopic dermatitis, although atopic dermatitis alone may cause chronic hand and foot dermatitis. It can be difficult to definitively distinguish the two disorders without additional findings of atopy (a history of atopic dermatitis, allergies/hay fever, and/or asthma). Allergic contact dermatitis also often occurs on the feet but tends to involve the top side.