What is the definition of Ledderhose Disease?
Ledderhose disease is a type of plantar fibromatosis characterized by the growth of hard and round or flattened nodules (lumps) on the soles of the feet. It is generally seen in middle-aged and elderly people, and occurs in men about 10 times more often than in women. It typically affects both feet and progresses slowly, but not indefinitely. The nodules are often painless at first, but may cause pain when walking as they grow. People with Ledderhose disease may also have other conditions associated with the formation of excess fibrous connective tissue such as Dupuytren contracture, knuckle pads, or Peyronie disease. Repeated trauma, long-term alcohol consumption, chronic liver disease, diabetes, and epilepsy have also been reported in association with this condition. The exact cause of Ledderhose disease is not known, but heredity is thought to play a role in many cases. Treatment, if needed, may involve conservative management, steroid injections, radiotherapy, or surgery (fasciectomy and removal of the fibrous tissue). The condition has a good prognosis, although slow progression is not uncommon. Fasciectomy has been shown to reduce the rate of recurrence.
What are the alternative names for Ledderhose Disease?
What are the current treatments for Ledderhose Disease?
Treatment options may include conservative management, radiation therapy, steroid injections and surgery. Conservative management may include using soft inserts in shoes. It may help to cut holes in the inserts or inner soles to reduce pressure on the nodules. Radiation therapy may help to stop disease progression in early stages, when nodules are very small. It may also help to shrink the size of larger nodules to relieve pain. Corticosteroid injections may be beneficial in the early stages of the disease, when there is no pain or minimal pain. If or when steroids do not help, surgery may be needed. Surgical options include fasciectomy and excision (removal) of the fibrous tissue. Fasciectomy has been shown to reduce the rate of recurrences. However, recurrence following surgery remains common.
The International Dupuytren Society provides further information on treatment options for Ledderhose disease.