Occurrence of Juvenile Plantar Eczema

Juvenile Plantar Eczema or "foot eczema" is skin inflammation triggered by friction of the sole of the foot often from rubbing against the inside of an ill-fitting synthetic athletic shoe or trainer. After its first report in 1968, it has been described under a variety of names (e.g. juvenile plantar dermatitis, forefoot dermatitis, atopic winter feet, dermatitis plantaris sicca, forefoot eczema, peri-digital dermatitis, sweating sock dermatitis) depending on the belief concerning its cause and possible association with atopy. Juvenile plantar eczema affects mainly children. One or both feet may be involved and sometimes the hands. Juvenile plantar eczema is seen most often in boys between 3-15 years of age, but it occasionally occurs in adults. When it occurs in children it does tend to gradually improve. It is usually most severe during the summer months.

It has become particularly common in recent years since athletic shoes have become more fashionable. Changing to leather footwear and wearing cotton socks may help relieve the problem. Above all else it is important that the footwear fits well and the sole of the foot is not sliding against the insole of the shoe. Emollients or ointments may be required.

Causes of Juvenile Plantar Eczema

The synthetic materials or chemicals used in the shoes or socks often play an important role in foot eczema. Sweat retention and occlusion of the feet by woolen or polyester socks. Keeping the foot for a long time in a shoe or sock without aeration is an important triggering factor.

Walking barefooted on woolen or polyester carpets may contribute to juvenile plantar eczema. This may lead to static electric charges that may also have a role in skin dryness and initiation of this condition.

Symptoms of Juvenile Plantar Eczema

Juvenile plantar eczema is characterized by symmetrical smooth, red-glazed appearance of the skin with fissuring, loss of epidermal ridge pattern, and fine scaling. It causes the sole of the foot to become red, hot, and sore. It has a predilection for the distal parts of the soles and toes; particularly the great toe, sparing the intertriginous spaces.

The average age for juvenile plantar eczema or foot eczema to occur is between 3-15 years of age but it occasionally occurs in adults. The most common symptoms are redness, irritation, cracking, and soreness, itching is seldom reported. The plantar surfaces of the larger toes are the first areas to be involved. Other weight-bearing areas are subsequently affected, but there is relative sparing of the instep and inter-digital web spaces of the foot.

Controlling Juvenile Plantar Eczema

To control or manage foot eczema, the following recommendations may be helpful:

  • Avoid walking barefooted.
  • Wear well-fitting shoes, preferably leather, with two pairs of cotton socks.
  • Use greasy moisturizers can be very helpful, including Vaseline, particularly when applied after a bath and before bed. Dimethicone barrier creams are easier to use during the day, applied every four hours.
  • Schedule quiet times with little or no walking to allow the fissures to heal.
  • Cover fissures in the feet to aid in faster healing. Plasters are usually satisfactory. Superglue can be applied to the fissure and will relieve the pain. Take care not to stick the toes together!
  • Use prescribed topical steroid ointments, but these rarely prove more effective than simple emollients. The more potent products are worth a trial for a couple of weeks. If helpful, they should then be reserved for a flare-up, particularly if the affected skin is red or itchy.
  • Apply Eczema-Ltd III disks to the affected areas.