Crutchfield Dermatology Case-of-the-month header image

Case of the Month

Piezogenic Pedal Papules

What are the bumps on this woman’s heel?

40 year old woman present with odd bumps on her heal she noticed ‘a few months ago’ when standing poolside and a friend, in the water, pointed them out. She is slightly overweight but was otherwise healthy and has been taking a statin medicine, baby aspirin, and multi-vitamin for the past 2 years. She reports that the bumps were completely painless and she knew of no other family members with similar “heel bumps.”

What's Your Diagnosis?

Piezogenic Pedal Papules

Piezogenic Pedal Papules can be painful or completely painless, as in this case. In fact, the majority of cases I have seen over the years are actually painless, although the name in some books and reports is listed as: “Painful Piezogenic Pedal Papules.”

They represent fat nodules that herniate through the dermis on the heel. The nodules become apparent and protrude with pressure (standing), as seen in the photo of this patient standing on a foot stool. Piezogenic Pedal Papules are relatively common and do not appear to have a genetic basis/connection. They do not appear to be a harbinger for any other connective tissue disease. There have been rare reports of a similar condition happening near the palms/wrists. In most cases, the treatment is reassurance.

Charles Crutchfield III M.D. Eagan Dermatologist

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