Painful fat herniation

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Painful fat herniation
Specialty Dermatology
Piezogenic papules on the heel of an individual with Ehlers-Danlos syndrome. Piezogenic papules.jpg
Piezogenic papules on the heel of an individual with Ehlers-Danlos syndrome.

Painful fat herniation is foot pain caused by the herniation of fat through the thin fascial layers of the weight-bearing parts of the heel. [1] The herniation results in small bumps called piezogenic pedal papules [1] or piezogenic papules. [2] Though piezogenic papules are most commonly found on the heel, they can also be found on the wrist and palm. [3]

Fascia layer of fibrous connective tissue that surrounds muscles, blood vessels and nerves

A fascia is a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs. Fascia is classified by layer, as superficial fascia, deep fascia, and visceral or parietal fascia, or by its function and anatomical location.

Heel part of the foot

The heel is the prominence at the posterior end of the foot. It is based on the projection of one bone, the calcaneus or heel bone, behind the articulation of the bones of the lower leg.

Contents

Piezogenic papules are relatively common; in one population-based study, the prevalence was found to be 2.5%. [4] [3] They occur more frequently in runners, triathletes, and individuals exposed to long periods of standing. [4] They are also common in individuals with connective tissue disorders, especially Ehlers Danlos Syndrome. [5] [4] However, due to their preponderance in the general population, the presence of piezogenic papules alone does not automatically indicate the presence of Ehlers-Danlos syndrome. In most cases, piezogenic papules are of little clinical significance.

A connective tissue disease is any disease that has the connective tissues of the body as a target of pathology. Connective tissue is any type of biological tissue with an extensive extracellular matrix that supports, binds together, and protects organs. These tissues form a framework, or matrix, for the body, and are composed of two major structural protein molecules: collagen and elastin. There are many different types of collagen protein in each of the body's tissues. Elastin has the capability of stretching and returning to its original length—like a spring or rubber band. Elastin is the major component of ligaments and skin. In patients with connective tissue disease, it is common for collagen and elastin to become injured by inflammation (ICT). Many connective tissue diseases feature abnormal immune system activity with inflammation in tissues as a result of an immune system that is directed against one's own body tissues (autoimmunity).

See also

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FKBP14 is a gene which codes for a structural protein named FKBP prolyl isomerase 14. This protein is believed to aid in the process of procollagen folding and is located in the endoplasmic reticulum that functions to process and transport proteins. Procollagens are collagen precursors located in the extracellular matrix that give tissues elasticity, strength, and support. This gene is involved in patterning the collagen structure. FKBP prolyl isomerase 14 may also be involved in altering other factors in the extracellular matrix. Mutations of this gene are associated with the kyphoscoliotic type of Ehlers-Danlos syndrome. This condition is characterized by a high range of joint movement, muscle atrophy, curved spine, and delicate cardiovascular vessels. These symptoms are brought about by a loss of the protein which results in a disruption of endoplasmic reticulum activities and extracellular matrix organization. FKBP14 mRNA levels are found higher in ovarian cancer tissues than healthy ovarian tissue and knocked down expression of FKBP14 by lentiviral shRNA leads to an impaired proliferative ability of ovarian cancer cells.

References

  1. 1 2 James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN   978-0-7216-2921-6.
  2. ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1371. ISBN   978-1-4160-2999-1.
  3. 1 2 "What Are These Papules?". The Dermatologist. HMP. Retrieved 2019-06-22.
  4. 1 2 3 Rocha Bde O, Fernandes JD, Prates FV (2015). "Piezogenic Pedal Papules". An Bras Dermatol. 90 (6): 928–9. doi:10.1590/abd1806-4841.20154884. PMC   4689092 . PMID   26734885.CS1 maint: Multiple names: authors list (link)
  5. ↑ Malfait F, Francomano C, Byers P, Belmont J, Berglund B, Black J, Bloom L, Bowen JM, Brady AF (2017). "The 2017 international classification of the Ehlers-Danlos syndromes". Am J Med Genet C Semin Med Genet. 175 (1): 8–26. doi:10.1002/ajmg.c.31552. PMID   28306229.CS1 maint: Multiple names: authors list (link)
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