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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2001 September;25(3):175-80
Epidermal keratinous cyst of the sole of the foot. A case report
Parino E., Milano L., Taraglio S.
We report a case of epidermal keratinous cyst on the sole of the foot which developed at the level of surgical scarring. Keratinous cysts, which have been reported in other areas but are rare on the sole of the foot, develop owing to the dispersion of horny lamellae from the superficial epidermal layers in the subepidermal tissues and the consequent onset of a cystic reaction in response to an extraneous body. We report the case of a 48-year-old woman suffering from recurrent 2nd and 3rd metatarsalgia as the sequelae to neurectomy following Civinini-Morton's syndrome. The presence of a hyperkeratinous lesion, which was very painful to the touch and corresponding to an earlier longitudinal surgical scar on the sole of the foot, led to the diagnosis of intractable plantar keratosis. We proceeded to make an extensive excision of the skin lesion, which was then covered with a rotation flap, associated with metric and functional re-equilibrium of the 2nd and 3rd metatarsal phalanges. The nature of the epidermal keratinous cyst was only confirmed by histological analysis. In addition to iatrogenic factors, keratinous cysts develop as a result of trauma or congenital factors, and although they are relatively frequent on the foot, when found on the sole of the foot they are often confused with warts or corns. We have reported the criteria for the differential diagnosis of epidermal keratinous cysts accompanied by a short bibliographic review.