Juvenile Forefoot Dermatitis

In the summer months children who wear occlusive tennis shoe like footwear and who’s feet sweat excessively, can present with this rash. It involves the forefoot and sometimes the heels but spares the instep. It also spares the deep web spaces between the toes. It is known as juvenile forefoot dermatitis. It was first reported in the late sixties and may have been related to changing fashions in footwear and socks. Histology shows an eczema and a blocking of sweat glands. Sometimes the tips of the fingers can be fissured as well and this is more common in atopic subjects which was the case in this boy. The condition clears in late childhood or adolescence. He did have negative patch testing to exclude a true footwear allergy. Treatment is cotton socks and leather shoes plus a strong steroid ointment initially and good moisturising thereafter. Tar such as 1% LPC in emulsifying ointment also works.