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A young teenage lad presented with "lumps" on all digits that have been present for some time and are increasing in size. These are becoming increasingly painful. The 1st toes have the largest lumps, are the sorest and all lumps are in the middle of the fat pads on the plantar aspect of the digits.

The lumps/nodules are within the dermis and are soft to palpate. I have not seen anything like this in 30 + years:confused: so I would appreciate some help. Thanks

This young man has downs syndrome and hypothyroidism apart from this his general health appears good.

His GP referred him with results from an ultrasound. The results were unremarkable with no diagnosis.

I have spoken to my local dermatologist who was unable to shed any light on this case.

I am trying to add some photos but as this is the first time in my many posts that I have tried to do this and I am not having much luck.:bang:

Cheers

 

:D maybe this time!

 

PS thanks to my fantastic team member Chantel for taking the pictures and asking for my opinion.

Cheers

 

Hi Heather,
Whatever the cause of these lumps, l would suggest as part of the treatment plan, to start and have his shoes modified to a rocker sole.

This should give quite a bit of reilf immediatley for your client during the gait cycle, whilst you further investgate and treat the condition.

Good luck

 

A neurofibromatosis perhaps, I´ll do a biopsy (sorry by my english)