RESUMEN
Aim To describe an uncommon clinical finding and raise awareness of its manifestation and associated conditions. Methods This case describes a gentleman with bilateral plantar fibromatosis caused by type 2 Diabetes Mellitus and previous alcohol excess. Results Treatment options include physiotherapy, steroid and collagenase injection therapy. Surgical intervention can be considered for persistently symptomatic or recurrent cases. Discussion In conclusion, plantar fibromatosis is an under-recognised and disabling condition which should prompt intervention and optimisation of co-morbidities.
Asunto(s)
Fibromatosis Plantar/diagnóstico , Alcoholismo/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Contractura de Dupuytren/complicaciones , Contractura de Dupuytren/diagnóstico , Fibromatosis Plantar/complicaciones , Infecciones por VIH/complicaciones , Hepatitis C Crónica/complicaciones , Humanos , Hipertensión/complicaciones , Masculino , Persona de Mediana EdadRESUMEN
Ledderhose disease or plantar fibromatosis is a rare hyperproliferative disorder of the plantar aponeurosis, clinically characterized by nodules situated especially on the medial border of the foot. It is histopathologically associated with Dupuytren's disease. This disease has some risk factors, like old age, alcohol or nicotine abuse, liver dysfunction, trauma or exposure to vibrations and autoimmune disorders, but the exact etiology is still unknown. Even though it is benign, the local manifestations can be aggressive, leading to debilitating deformities and contractures of the toes. Ultrasound and magnetic resonance imaging are used to confirm the diagnosis and to eliminate other disorders. Whenever is possible, the conservative therapies are recommended. Having a high recurrence, Ledderhose disease can be hard to treat, needing multiple surgical interventions. This paper aims to cover all the important aspects of this disease for daily medical practice, from history to clinical manifestations, diagnostic methods and histopathological features, to conservative and surgical treatment modalities.
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Fibromatosis Plantar/patología , Fibromatosis Plantar/terapia , Fibromatosis Plantar/diagnóstico , Fibromatosis Plantar/cirugía , HumanosRESUMEN
Plantar fibromatosis (morbus Ledderhose), an extra-abdominal desmoid tumor of the plantar foot, is a rare benign hyperproliferative disorder of the plantar fascia with an unknown etiology. The main clinical characteristics include slow growing nodules on the medial and central bands of the plantar fascia, which may become painful and negatively affect ambulation. Most established conservative therapies today target symptomatic relief. As symptoms progress, therapies such as injections, shockwave ablation, radiation, and/or surgery may be required. This review aims to provide insight into the pathophysiology of this condition in addition to detailing current and investigational therapies for this disorder. Many therapies have been proven in similar conditions, which could lead to promising treatment options for plantar fibromatosis. LEVELS OF EVIDENCE: Level V: Expert opinion.
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Tratamiento Conservador/métodos , Fibromatosis Plantar , Enfermedades del Pie , Procedimientos Ortopédicos/métodos , Biopsia , Diagnóstico por Imagen , Fibromatosis Plantar/diagnóstico , Fibromatosis Plantar/fisiopatología , Fibromatosis Plantar/terapia , Enfermedades del Pie/diagnóstico , Enfermedades del Pie/fisiopatología , Enfermedades del Pie/terapia , HumanosRESUMEN
A 21-year-old mentally challenged man presented with a fixed plaque lesion on the right foot, which had been present for 10 years. Dermatologic examination revealed an erythematous, painful, firm, fixed plaque-nodular lesion on the plantar aspect of the right foot (Figure 1A). Nothing of distinction was noted from his family history or his laboratory tests. An incisional biopsy revealed parallel, regular bundles composed of uniform, plump spindle cells. Thin collagen fibers were seen in contact with and located between the spindle cells. This mass was separated from the surrounding soft tissue by an irregular, unclear border (Figure 2A). Immunohistochemically, the spindle cells showed diffuse, strong reactivity to vimentin (Figure 2B) and smooth muscle actin.
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Antiinflamatorios/uso terapéutico , Fibromatosis Plantar/diagnóstico , Fibromatosis Plantar/tratamiento farmacológico , Triamcinolona Acetonida/uso terapéutico , Antiinflamatorios/administración & dosificación , Fibromatosis Plantar/complicaciones , Fibromatosis Plantar/patología , Humanos , Inyecciones Intralesiones , Discapacidad Intelectual/complicaciones , Imagen por Resonancia Magnética , Masculino , Triamcinolona Acetonida/efectos adversos , Adulto JovenRESUMEN
Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma usually presenting in proximal extremities of middle-aged men. The authors discuss a unique case of EMC, localized in the plantar foot of a 76-year-old woman, clinically suspected as plantar fibromatosis. It is important to avoid misdiagnosis of EMC because of their propensity for late recurrence and their metastatic potential.