WHAT ARE PIEZOGENIC PAPULES?Piezogenic papulesThese are small bumps on the heel, on the sides of the heel, that appear due to pressure. They are visible when standing and disappear when the foot is not weight-bearing. They are outward protrusions of fatty tissue. The name is derived from the Greek word "piesis," meaning "pressure." Papule is the medical term for a bump. It is also called piezogenic pedal papules (pedum = foot). It is a benign condition.WHAT DO PIEZOGENIC PAPULES LOOK LIKE?Several skin-colored or yellowish bumps are visible on the heel, especially on the sides. The bumps are visible when standing and disappear when the foot is no longer weight-bearing. The bumps usually cause no symptoms. Sometimes (in a minority of cases) they cause pain when walking or standing for extended periods. They are equally common in men and women. They appear in adulthood. Overweight people are more likely to experience them.
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HOW ARE PIEZOGENIC PAPULOSES FORMED?The sole of the foot endures a lot because we stand on it all day. That's why the skin on the sole of the foot is very thick. It has a thick stratum corneum (callus) and the dermis, made of strong connective tissue, is also thicker. Underneath this is a layer of fat that acts as a kind of cushion/shock absorber. This fat layer is veined with strong partitions of connective tissue. In some people, the connective tissue is no longer intact everywhere, and then fat can bulge outward when standing. This can happen easily. It can also occur with congenital weakness of the connective tissue, for example, in Ehlers-Danlos syndrome. It can also occur with obesity, because then there is more pressure on it. Sports (endurance sports, long-distance running) are also mentioned as possible causes.HOW IS THE DIAGNOSIS MADE?The diagnosis is based on the clinical picture, i.e., the appearance. No additional testing is necessary.HOW ARE PIEZOGENIC PAPULES TREATED?Treatment isn't necessary, and there aren't any effective treatments. For painful piezogenic papules, you can try to relieve the pressure by wearing an elastic stocking. Or wear a roomy orthopedic shoe with a custom-molded silicone insole that encloses the entire heel.WHAT ARE THE OUTLOOK?Piezogenic papules don't go away. More usually appear over the years. |
