Juvenile plantar dermatosis
Juvenile plantar dermatosis (also known as juvenile forefoot dermatitis) is uncommon; it is most often seen in children who are atopic. Prognosis for juvenile plantar dermatosis is good, and it usually remits by puberty. It affects the anterior portion of the plantar surface of the foot; the skin becomes erythematous, glazed and fissured. Occasionally, the fingertips are also affected. For a photo of juvenile plantar dermatosis, see here.
Juvenile plantar dermatosis often cycles between intense inflammation, cracking, and cracking with extreme dryness. Pain from the fissures is the main symptom, rather than itch.
The condition tends to be better in winter (when shoes and socks are worn) and worse in summer (when feet are less covered). Avoid skin irritants (eg soap and shampoo), and use a soap substitute.
During acute episodes of intense inflammation, use:
betamethasone dipropionate 0.05% ointment topically, once daily at night for 1 to 2 weeks until skin is clear. betamethasone dipropionate
If the inflammation is particularly severe, apply the topical corticosteroid under a wet dressing (eg damp socks).
As the inflammation subsides, apply an emollient twice daily. If there are no cracks, use a urea-based emollient (eg urea 10% cream [with or without lactic acid or sodium pyrrolidone carboxylate]). Use a plain emollient in children; avoid using urea creams in children because they can sting and cause pain (particularly when the skin is inflamed or cracked).
Topical corticosteroids do not help when the skin is dry or cracked. During phases when the skin is cracked, use glycerine 10% in sorbolene or aqueous cream twice daily as an emollient, and also apply:
compound benzoin tincture 4% in yellow soft paraffin topically on the cracks, once or twice daily1. benzoin tincture + paraffin
For faster healing, apply the tincture and then tape the cracks with hypoallergenic adhesive tape.
During phases when the skin is dry and cracked, use:
compound benzoin tincture 4% in yellow soft paraffin topically on the cracks, once daily in the morning1 benzoin tincture + paraffin
AND
LPC 3% in sorbolene or aqueous cream topically, once daily at night before bed2. coal tar
