Diagnostic Considerations
Infantile pedal papules are fairly common, nontender, congenital nodules located on the medial plantar aspects of the foot. This condition has been described as precalcaneal congenital fibrolipomatosis hamartomas, bilateral congenital adipose plantar nodules, benign anteromedial plantar nodules of childhood, congenital piezogeniclike pedal papules, bilateral congenital fatty heel pads, and pedal papules of the newborn. They are most common at age 1 year and typically disappear between ages 2 and 3 years. Infantile pedal papules do not accentuate upon standing. The etiology is unknown.
Autosomal dominant precalcaneal congenital fibrolipomatous hamartoma is rare. [17, 18] Lesions were flesh colored and in the midline of each heel (plantar). They are symmetric and bilateral. These persisted up to puberty and beyond (age 20 y) in one case. Histologically, they are mature adipose tissue. No other associated malformations were reported.
Acrokeratoelastoidosis of the foot may be mistaken for piezogenic pedal papules. [19]
Differential Diagnoses
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Piezogenic pedal papules. Courtesy of DermNet New Zealand (https://www.dermnetnz.org/assets/Uploads/dermal-infiltrative/piezogenic-papules5.jpg).
