A Case of Degenerative Neuropathy Showing Plantar Tenderness

Lee, Hyun Joo; Lee, Seok Jong; Jun, Jae Bok

Abstract

Morton's neuroma is most likely a mechanically-induced degenerative neuropathy which originally has a strong predilection for the third common digital nerve in middle-aged women. But similar histopathologic changes can be found elsewhere in the sole. We herein report a 52-year old woman showing tenderness on her heel for 2 months without any other skin lesion. The pain was aggravated by walking and palpation, relieved by resting. Histopathologic findings showed nerve fiber degeneration, intraneural and perineural fibrosis, and thickening of blood vessel walls, which was alike that of Morton's neuroma. After conservative treatment had been failed, we excised the painful area which showed degenerative nerve fiber in the histopathologic examination. The pain disappeared after operation and there was no recurrence for 15 months. Although it showed same histopathologic features with Morton's neuroma, it is not the usual predilection site. We diagnosed it degenerative neuropathy in the plantar area and we think this is the first report in Korean dermatologic literatures. It is worthwhile considering a degenerative neuropathy in the case of painful skin without any other skin lesion.