Ledderhose disease or plantar fibromatosis: what does it consist of?

Ledderhose disease or plantar fibromatosis is a rare disease of unknown cause in which benign hyperproliferation of the plantar fascia occurs —Thick tissue on the sole of the foot. This promotes the appearance of connective tissue nodules, also known as fibroids.

According to research journals, this pathology affects 1.2 out of every 10,000 inhabitants and 6 out of 10 patients are male. Due to this low incidence, it is considered a rare disease with a very atypical presentation.

What is Ledderhose disease?

As we have said, Ledderhose disease or plantar fibromatosis consists of the appearance of benign lumps on the sole of the foot, that is, not carcinogenic. As various studies indicate, it is much more common in men —10 times more—, even more if they are in a middle-aged range.

It should be noted that 50% of patients with Ledderhose disease also suffer from Dupuytren's disease or palmar fibrosis, characterized by a thickening of tissue under the skin of the hands. Conversely, palmar fibrosis is accompanied by plantar fibrosis in only 3% of cases.

This pathology has a more frequent presentation among men than among women.

To know more: Benign tumors, everything you need to know

What are your causes?

The cause of Ledderhose disease is still unknown. It has been associated with repeated trauma to the sole of the foot and certain hereditary genetic processes, but their mechanisms of emergence are heterogeneous and diffuse.

Other studies indicate that this pathology can also be associated with diseases such as diabetes, epilepsy, chronic liver deficiencies, chronic alcoholism, other fibromatosis and trauma. As we have already said, plantar fibromatosis is associated in half of cases with Dupuytren's disease.

Dupuytren's disease has a clear genetic and inheritance component, but the same cause has not yet been associated with plantar fibromatosis.

Characteristic symptoms of Ledderhose disease

Without a doubt, the clearest symptom of the disease is appearance of one or more superficial bumps – 0.5 to 3 centimeters in diameter – on the soles of one or both feet. Patients often describe these formations as hard and with well-defined edges, as if they had a stone under the skin.

At first, these nodules are not painful, but as they grow and infiltrate more internal tissues, they can cause discomfort in the patient when supporting the affected foot. In general, a toe contracture does not usually occur, unless the training affects the location and function of a tendon.

Diagnosis

In general, the diagnosis is based on differentiating the origin of the strange lump on the sole of the foot: this can be due to Ledderhose disease, plantar fasciitis or a soft tissue tumor, for example. Therefore, as indicated by the EM portal, consult, The medical professional usually resorts to performing an ultrasound of the affected area.

When there is any doubt about the origin of the swelling on the sole of the foot after ultrasound, diagnostic support can be sought on an MRI. These techniques detect spindle-shaped nodules and the characteristic thickening of the plantar fascia.

Treatment of Ledderhose disease

The therapeutic means to face this pathology are diverse. The following measures are the most used almost always:

  • The most conservative treatment is based on the use of orthoses Bandage-like foot supports. This is accompanied by stretching, proper footwear, and the modification of certain habits.
  • Infiltration of corticosteroids into the tissue can reduce the size of the nodules. The effects begin to be noticed after three months of treatment.
  • Shock waves and proteolytic enzymes can be used, although these treatments are in the experimental phase.

Surgery is only contemplated in patients who experience pain when supporting the foot. The reason is that, unfortunately, the chances that the nodule will reappear after extraction is quite high.

Pain is not a characteristic sign, but if it is frequent, it will require evaluating surgery.

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A rare foot pathology

As you may have observed in these lines, Ledderhose disease it is rare, not very aggressive and affects the patient locally on the foot. Treatment is usually based on the application of drugs and support techniques, but surgery is only conceived in the most bothersome cases.

Unfortunately, given the likelihood of recurrence and the unknown cause of the condition, the nodules may accompany the patient for life. Still, it is a disorder that, with proper footwear and medical support, is not a big problem on a day-to-day basis.

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