[Painful nodular and plantar erythema in children]. / Erythème nodulaire plantaire douloureux de l'enfant.

ABSTRACT

INTRODUCTION: According to our knowledge, only twenty-three similar cases have been reported in the literature. Possible hypotheses for localised painful red nodules on the feet in children include erythema nodosum, neutrophilic eccrine hidradenitis, traumatic plantar urticaria, vasculitis and cold panniculitis. CASE REPORT We report a typical case of painful erythematous plantar nodules of the child. A 13-yr-old boy was first seen by a paediatrician for intermittent fever. The fever was associated with red, painful nodules on the soles. He was unable to walk. Routine blood chemistry parameters were within normal limits. Histopathologic examination of lesional skin revealed an image of septal and lobular panniculitis with vasculitis. Direct immunofluorescence study was not contributive. With proper antibiotic therapy, pain resolved within one week while fever and nodules cleared within two weeks. DISCUSSION: Briefly, this observation concerns a child disease occurring as painful erythematous plantar nodules. The lesions are spontaneously resolutive and the children are in good health. Our observation should constitute a supplementary group with the same classical symptoms of nodular plantar painful erythema of the child but moreover accompanied by a septal and lobular panniculitis with vasculitis at the histological examination. Further studies are necessary to verify these hypotheses.