Medscape is available in 5 Language Editions – Choose your Edition here.


Plantar Fibromatosis Differential Diagnoses

  • Author: Firas G Hougeir, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Jun 03, 2016

Diagnostic Considerations

Also consider the following:

  • Scar and keloid
  • Sarcoma
  • Fasciitis
  • Neurofibroma
  • Achromic neuroid nevus and malignant melanoma
  • Serous tendinous cyst
  • Mucoid cyst
  • Calcinosis
  • Osteoma and calcaneus spur
  • Gout

Clinically, Lederhose disease can be confused with posttraumatic neuroma. However, Lederhose disease is usually bilateral, although one side may be more prominent than the other. Clear cell sarcoma must be considered when MRI findings lead to the diagnosis of Lederhose disease.

Superficial plantar fibromatosis must be distinguished from the other types of fibromatoses (eg, juvenile aponeurotic fibroma, aggressive infantile fibromatosis), but, even histologically, this identification is often not easy. Other conditions that may mimic superficial plantar fibromatosis are deep granuloma annulare, calcinosis, mucoid cyst, and Darier-Ferrand dermatofibrosarcoma (dermatofibrosarcoma protuberans). Granuloma annulare usually involves more than one element. Calcinosis and osteoma feel harder than superficial plantar fibromatosis and are easily visible on radiographs. Mucoid cysts are renitent. They grow relatively slowly, and their sizes vary; however, the differences in size are seen on a weekly, not necessarily daily, basis. Darier-Ferrand dermatofibrosarcoma usually involves pigmented overlying skin and has a slower evolution. In any case, biopsy is necessary to confirm the diagnosis.

Hamartomatous plantar fibromatosis must be distinguished from neurofibroma, neurofibromalike melanocytic nevus, and melanoma arising in a neurofibromalike nevus. The correct diagnosis can be obtained only with microscopic examination.

Differential Diagnoses

Contributor Information and Disclosures

Firas G Hougeir, MD Staff Dermatologist, Private Practice, Georgia

Firas G Hougeir, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American College of Rheumatology

Disclosure: Received income in an amount equal to or greater than $250 from: XOMA; Biogen/IDEC; Novartis; Janssen Biotech, Abbvie, CSL pharma<br/>Received honoraria from UpToDate for author/editor; Received honoraria from JAMA Dermatology for associate editor and intermittent author; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for i inherited these trust accounts; for: Celgene; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble; Amgen.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Neil Shear, MD Professor and Chief of Dermatology, Professor of Medicine, Pediatrics and Pharmacology, University of Toronto Faculty of Medicine; Head of Dermatology, Sunnybrook Women's College Health Sciences Center and Women's College Hospital, Canada

Neil Shear, MD is a member of the following medical societies: Canadian Medical Association, Ontario Medical Association, Royal College of Physicians and Surgeons of Canada, Canadian Dermatology Association, American Academy of Dermatology, American Society for Clinical Pharmacology and Therapeutics

Disclosure: Nothing to disclose.


Jose M Mascaro, MD, MS Chairman, Professor, Department of Dermatology, Hospital Clinic, University of Barcelona, Spain

Jose M Mascaro, MD, MS is a member of the following medical societies: American Dermatological Association, American Society of Dermatopathology, and International Academy of Pathology

Disclosure: Nothing to disclose.

  1. McPoil TG, Martin RL, Cornwall MW, Wukich DK, Irrgang JJ, Godges JJ. Heel pain--plantar fasciitis: clinical practice guildelines linked to the international classification of function, disability, and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2008 Apr. 38(4):A1-A18. [Medline].

  2. Wiedemann HR, Burgio GR, Aldenhoff P, Kunze J, Kaufmann HJ, Schirg E. The proteus syndrome. Partial gigantism of the hands and/or feet, nevi, hemihypertrophy, subcutaneous tumors, macrocephaly or other skull anomalies and possible accelerated growth and visceral affections. Eur J Pediatr. 1983 Mar. 140(1):5-12. [Medline].

  3. Montgomery E, Lee JH, Abraham SC, Wu TT. Superficial fibromatoses are genetically distinct from deep fibromatoses. Mod Pathol. 2001 Jul. 14(7):695-701. [Medline].

  4. Morrison WB, Schweitzer ME, Wapner KL, Lackman RD. Plantar fibromatosis: a benign aggressive neoplasm with a characteristic appearance on MR images. Radiology. 1994 Dec. 193(3):841-5. [Medline].

  5. Bancroft LW, Peterson JJ, Kransdorf MJ. Imaging of soft tissue lesions of the foot and ankle. Radiol Clin North Am. 2008 Nov. 46(6):1093-103, vii. [Medline].

  6. Scheler J, Rehani B, Percy T, et al. Increased F-18 FDG uptake on positron emission tomography/computed tomography imaging caused by plantar fibromatosis. Clin Nucl Med. 2008 Apr. 33(4):280-1. [Medline].

  7. Alman BA, Naber SP, Terek RM, Jiranek WA, Goldberg MJ, Wolfe HJ. Platelet-derived growth factor in fibrous musculoskeletal disorders: a study of pathologic tissue sections and in vitro primary cell cultures. J Orthop Res. 1995 Jan. 13(1):67-77. [Medline].

  8. DeBrule MB, Mott RC, Funk C, Nixon BP, Armstrong DG. Osseous metaplasia in plantar fibromatosis: a case report. J Foot Ankle Surg. 2004 Nov-Dec. 43(6):430-2. [Medline].

  9. Evans HL. Multinucleated giant cells in plantar fibromatosis. Am J Surg Pathol. 2002 Feb. 26(2):244-8. [Medline].

  10. van der Veer WM, Hamburg SM, de Gast A, Niessen FB. Recurrence of plantar fibromatosis after plantar fasciectomy: single-center long-term results. Plast Reconstr Surg. 2008 Aug. 122(2):486-91. [Medline].

  11. Wapner KL, Ververeli PA, Moore JH Jr, Hecht PJ, Becker CE, Lackman RD. Plantar fibromatosis: a review of primary and recurrent surgical treatment. Foot Ankle Int. 1995 Sep. 16(9):548-51. [Medline].

Superficial fibromatosis of the heel.
Juvenile aponeurotic fibroma.
Hamartomatous fibromatosis.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.