Chapter 2. 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 with cracking and fissuring on the distal plantar surfaces of the feet and toes (PICTURE A). It is less commonly seen on the palmar surfaces. It is though to be triggered by alternating excessive hydration with moisture loss. Fissuring may become quite extensive and can cause considerable discomfort. 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, so tends to subside in the summer months. Juvenile palmar-plantar dermatosis generally remits by puberty.
The disorder is often worse in atopic patients 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. Allergic contact dermatitis also often occurs on the feet but tends to involve the dorsal surfaces.