Ledderhose Disease: Pathophysiology Diagnosis and Management

Abstract

Introduction: Ledderhose's disease, also known asplantar fibromatosis, is a rare benign nodular hyperplasia of the plantar aponeurosis. The disease is locally aggressive and can be managed very well conservatively. In patients who present with severe pain on weight-bearing might require surgical excision.

Case report: We would like to report about a case of 40-year-old female with bilateral Ledderhose's disease. She was treated conservatively to no avail. On surgical excision of the fibrosis tissue, the patient gives complete relief of symptoms. In this paper, we would to discuss both the conservative and surgical methods adopted to prevent post-operative complications.

Conclusion: Ledderhose disease is a rare benign aggressive disease which presents as nodules over the sole of the foot. The disease is usually manageable conservatively. Wide margin surgical excision of the nodule in severe cases will provide pain-free mobilization and prevent recurrence.

Keywords: Heel pain; Ledderhose’s disease; Plantar fibromatosis; Swelling.

Figure 1

X-rays.

Figure 2

Magnetic resonance imaging.

Figure 3

Skin incision.

Figure 4

The nodule.

Figure 5

After excision.

Figure 6

Post-operative healed wound.

Figure 7

Histopathology slide:Photomicrograph of HPE slide showing HNE stained at ×40 showing ill-circumscribedlesion composed of spindle-shaped cells in a fibrous stroma background.

Figure 8

Histopathology slide:Photomicrograph of HPE slide showing HNE stained at ×100 showing bland spindle-shaped cells with abundant collagen in a fibrous stroma background.