Plantar fascial fibromatosis
Definition
Ledderhose disease is a benign disease of the connective tissue of the feet. It occurs in the area of the plantar aponeuroses (= Latin term for the tendon plate of the sole of the foot). More precisely, it is a thickening of the deep connective tissue or fascia of the foot.
Ledderhose disease belongs to the clinical picture of fibromatoses and is also related to Dupuytren’s disease, which is a benign disease of the connective tissue of the palm of the hand. The nodes on the soles of the feet usually grow very slowly, and are almost always centered on the plantar fascia (sole of the foot). Occasionally the growth of the nodes is delayed and they do not grow any further. Then they can suddenly grow again rapidly and unexpectedly. A surgical intervention is only necessary in the case of painful nodes that hinder walking.
Causes
The causes of the disease have not yet been fully clarified. It is known that the protrusion on the sole of the foot is caused by an increase in connective tissue at the affected area. More precisely, certain cells, the myofibroblasts, are responsible for this.
There are a number of different theories and conjectures which factors can influence the occurrence of Ledderhose disease. It is considered likely that a genetic component plays a role in the disease. Connective tissue changes occur when external factors such as injuries or other events of unknown nature are added.
The fact that men are affected about twice as often as women also speaks for a genetic influence. Further risk factors are the simultaneous presence of other fibromatoses – especially in Dupuytren’s disease – as well as certain diseases such as diabetes mellitus or epilepsy. There are also a number of different factors whose significance in the development of the disease has not yet been proven, although there are indications of this in individual cases. These include in particular the consumption of stimulants such as nicotine and alcohol as well as stress, and certain metabolic and liver diseases.
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