A cases series of Piezogenic pedal papules
A 19-year-old female admitted for numerous soft and round lesions on the heels that became prominent with standing. The lesions initially appeared on the lateral and posterior parts of both feet, and their size and number continued to increase over time. Standing and walking resulted in a continuous pain in the heels that gradually intensified. The pain subsided with the cessation of standing and walking, and also by applying pressure in areas of the feet other than the heels. The patient had no previous history of feet injuries and of excessive or continuous pressure exerted on the feet (due to factors such as excessive weight, jumping, etc.).\nWhen no pressure was applied to the lesions, they presented as soft, round, skin-colored and about 0.1-0.4 cm diameter papules on the outer edges of the heels. Under pressure, the lesions became harder, tense and painful []. One papular lesion was completely excised from the lateral of the patient's left foot. A histopathological evaluation revealed hyperkeratosis, irregular acanthosis, thickening of the dermis and small fat cell populations in the dermis (H-E staining, ×5) []. As the patient had complaints of pain and did not wish to undergo surgery, intralesional corticosteroid injection was performed twice. No improvement or recovery was detected on follow-up visits. The patient is currently under follow-up.