Piezogenic Papules

[Guest guest]

In a message dated 9/17/02 9:08:26 PM Central Daylight Time,

lrh@... writes:

> I read on the CEDA website that these are probably

> piezogenic papules, which usually aren't painful.

Hi Lenore,

I can't say if that is what these are or not, and truthfully, I can't exactly

remember at the conference, if what we were discussing was this, or if it was

the " fat pads " of the foot.

*Note* Never mind, I found the answer here:

http://www.medscape.com/viewarticle/405473_print

Take a look and see if this is what you are describing.

Anyway, there was a podiatrist at the annual conference, and he said custom

orthotics can be made to ease pain and such when this occurs. In fact, this

same article concurs with that. See below.

Treatment

If piezogenic papules are asymptomatic, no treatment is required. Treatment

of painful piezogenic pedal papules includes avoiding standing for long

periods and, if necessary, weight loss. Heel cups, footpads, and specially

constructed orthotics can be helpful. If the pain does not resolve with these

methods, excision of the papules can be curative.

I hope this is of some help to you. Is there a podiatrist near you? I would

get an appointment with one if I were you.

Love Lana

[Guest guest]

I have a good picture of a piezogenic papules that I will upload to yahoogroups

for anyone who wants to see what they look like. If you do not have a yahoo ID

and can't get to the yahoogroups page please let me know and I can send it along

to you as an attachment.

Piezogenic pedal papules usually reflect a benign condition consisting of normal

fat tissue that has extruded through the dermis. The papules usually appear on

the plantar aspect of the foot and heel and are more marked on the medial

aspect; they may also occur near the wrist and lateral borders of the hand. They

are visible only when the patient is weight bearing and immediately disappear in

a non­weight-bearing posture. Occasionally, the papules will be painful. This

has been attributed to ischemia of the herniated fatty tissue caused by

compressive compromise of its blood supply.

Piezogenic papules are most commonly diagnosed in otherwise healthy patients.

Usually, they are not suggestive of systemic diseases but they are often seen in

people with EDS. Because they are typically painless, they may go unrecognized.

They only impair musculoskeletal function if they cause pain from focal ischemic

effects, but ulceration does not occur.

Treatment of the papules is usually unnecessary unless they cause pain.

Therapeutic measures include use of heel pads and avoidance of prolonged

standing.

¸..· ´¨¨)) -:¦:-

¸.·´ .·´¨¨))

((¸¸.·´ ..·´ -:¦:- Jill

-:¦:- ((¸¸.·´

[Guest guest]

Thanks Jill. I've been doing quite of bit on research on these, for me,

bothersome things, and am still trying to get an appointment with a

podiatrist. The main solution I've found, as this article also says, is to

avoid standing, which I find it very hard to do, what with teaching, etc.

Sigh.

Lenore

> I have a good picture of a piezogenic papules that I will upload to

> yahoogroups for anyone who wants to see what they look like. If you do

> not have a yahoo ID and can't get to the yahoogroups page please let me

> know and I can send it along to you as an attachment.

>

> Piezogenic pedal papules usually reflect a benign condition consisting of

> normal fat tissue that has extruded through the dermis. The papules

> usually appear on the plantar aspect of the foot and heel and are more

> marked on the medial aspect; they may also occur near the wrist and

> lateral borders of the hand. They are visible only when the patient is

> weight bearing and immediately disappear in a non­weight-bearing posture.

> Occasionally, the papules will be painful. This has been attributed to

> ischemia of the herniated fatty tissue caused by compressive compromise

> of its blood supply.

> Piezogenic papules are most commonly diagnosed in otherwise healthy

> patients. Usually, they are not suggestive of systemic diseases but they

> are often seen in people with EDS. Because they are typically painless,

> they may go unrecognized. They only impair musculoskeletal function if

> they cause pain from focal ischemic effects, but ulceration does not

> occur.

>

> Treatment of the papules is usually unnecessary unless they cause pain.

> Therapeutic measures include use of heel pads and avoidance of prolonged

> standing.

>

> ¸..· ´¨¨)) -:¦:-

> ¸.·´ .·´¨¨))

> ((¸¸.·´ ..·´ -:¦:- Jill

> -:¦:- ((¸¸.·´

>

>

>

>

[Guest guest]

Yes, you are definitely in a profession where you have to stand a great

deal! Have you tried anything for relief that has worked, if even for a

short time?

Jill

[Guest guest]

I just spoke with my primary care person last week about

pain/antiinflammatory medication for the first time. Since I've always

been told, you don't have a serious type of EDS, I always figured I could

just live with all the painful " cosmetic " stuff (as the geneticist called

it). But after joining this list, I realized I can indeed try to use some

basic stuff so that hopefully I don't get so tired and discouraged with

painful, swollen feet, and whatever else. So now I am experimenting - you

have all

probably gone through this already - with simple Ibuprofen.

Thanks, all.

Lenore

> Yes, you are definitely in a profession where you have to stand a great

> deal! Have you tried anything for relief that has worked, if even for a

> short time?

>

> Jill

>

>

>

>

>

>

[Guest guest]

Hi Lenore,

I don't mean to butt in on this discussion, but I wanted to throw out something

I remembered from the EDNF conference this summer. The podiatrist there has

attended almost all the conferences for EDS, and it was his opinion that most

EDSers absolutely need and should be wearing orthotics. Do you have some for

your feet? I know for me, they made a big diference. Also, he showed a picture

of feet, where the " fat pads " (is that the same as Piezogenic Papules?) on this

lady's feet when she would stand on them, would be on the heels of her feet,

instead of on the bottoms, like they were supposed to be. He said they were

able to make her custom orthotics to keep them in place.

Also, I do have his name at home, and I'm sure you could email him with specific

questions you have. He's very knowledgeable, and he did say at the conference,

that our podiatrists could call him, should they ever have any questions.

Please let me know if you would like me to email you his name and email address,

OK??

I hope you find something that helps, I know how terrible you feel when your

feet hurt!

Love Lana

[Guest guest]

Lana, I'd like that podiatrist's name, thanks. I do have pretty good

orthotics, but none that are designed to keep that " fat pad " in place -

intriguing. But in the summer I simply cannot bear to wear the various

shoes that can hold my orthotics -- the degree of discomfort in

heat-caused swelling

outweighs the pain of not wearing orthotics, which of course makes those

feet hurt more by summer's end. I'll see if I can get better orthotics

made, and maybe find better summer shoes!

Lenore

On Fri, 11 Oct 2002

llchriste@... wrote:

> Hi Lenore,

>

> I don't mean to butt in on this discussion, but I wanted to throw out

> something I remembered from the EDNF conference this summer. The

> podiatrist there has attended almost all the conferences for EDS, and it

> was his opinion that most EDSers absolutely need and should be wearing

> orthotics. Do you have some for your feet? I know for me, they made a

> big diference. Also, he showed a picture of feet, where the " fat pads "

> (is that the same as Piezogenic Papules?) on this lady's feet when she

> would stand on them, would be on the heels of her feet, instead of on the

> bottoms, like they were supposed to be. He said they were able to make

> her custom orthotics to keep them in place.

>

> Also, I do have his name at home, and I'm sure you could email him with

> specific questions you have. He's very knowledgeable, and he did say at

> the conference, that our podiatrists could call him, should they ever

> have any questions. Please let me know if you would like me to email you

> his name and email address, OK??

>

> I hope you find something that helps, I know how terrible you feel when

> your feet hurt!

>

> Love Lana

>

>