Ledderhose disease: proliferation of connective tissue under the foot

Ledderhose disease involves an unwanted rapid growth of connective tissue under the feet. Closely related to Ledderhose disease are Peyronie’s disease and Dupuytren’s disease. What causes Ledderhose disease, what are the symptoms and what treatment options are available? Major research into the genetic cause of Ledderhose disease, Peyronie’s disease and Dupuytren’s disease is being conducted at the UMC Groningen. The research may lead to better treatment in the future.

Article content

  • Ledderhose’s disease
  • Explanation of the name of the disease: Ledderhose
  • Different names for Ledderhose disease
  • Cause of Ledderhose disease
  • Who can be affected by it?
  • Symptoms of Ledderhose disease
  • Diagnosis of Ledderhose disease
  • Treatment of Ledderhose disease
  • Prognosis, outlook of Ledderhose disease
  • Research at the UMC Groningen

Ledderhose’s disease

Ledderhose disease is related to Dupuytren’s disease , which is another form of fibromatosis. In Ledderhose disease, lumps (nodules) develop in the connective tissue under the foot. In Dupuytren’s disease, lumps, but also cords, develop on the hand.

Explanation of the name of the disease: Ledderhose

The condition was first described by German physician Georg Ledderhose in 1894.

Different names for Ledderhose disease

  • Morbus Ledderhose
  • Plantar fibromatosis
  • Nodular fibromatosis plantaris

Cause of Ledderhose disease

The cause of Ledderhose disease is not known. However, there are risk factors such as hereditary factors, smoking, alcohol, diabetes mellitus and long-term use of anti-epileptic drugs.

Who can be affected by it?

You can suffer from it at any age, but you are most likely to develop it in middle age and older. Men are more likely to suffer from the condition than women. There is also a connection with Dupuytren’s disease and Peyronie’s disease.

Symptoms of Ledderhose disease

  • Lumps, bumps under the foot.
  • If it is a large lump or is located on a pressure point, pain may occur while standing and walking. The pain is often most severe when you get out of bed, for example, it may involve cramps or shooting pains that last for a short time. These complaints usually disappear quickly after you have walked a bit.
  • Pressing feeling.
  • Burning feeling.
  • A feeling of tension.

Diagnosis of Ledderhose disease

The diagnosis can be made by means of MRI with Gadolinium staining.

Treatment of Ledderhose disease

  • If you compare the treatment with that of Dupuytren’s disease, the treatment of the foot (Ledderhose) is more difficult than that of the hand (Dupuytren). With Ledderhose disease you see the nodules return earlier and they adhere more to the nerves (than with Dupuytren’s).
  • The advice is often to stretch the tendon plate under the foot as little as possible. This can be achieved, for example, by wearing shoes with stiff soles.
  • A podiatrist can make a podiatric sole to reduce the stretch on tendon fibers and a recess can be made where the lumps are.
  • Irradiation (radiotherapy) is a possible treatment if you have Ledderhose disease. Radiation can reduce the symptoms and can also prevent the disease from getting worse. Preferably, radiation should be given at an early stage of Ledderhose disease. Ask whether radiation is reimbursed.
  • If the pain persists, surgical intervention is an option: fasciotomy of the plantar aponeurosis (this is the tendon plate that connects the metatarsal bones to the heel bone).
  • After the lumps have been removed, you may experience post-operative scars. Possible complication of surgery: post-traumatic dystrophy.

Prognosis, outlook of Ledderhose disease

It is not possible to predict how the condition will progress. Even without treatment, the condition may not worsen. After treatment, the symptoms may return.

Research at the UMC Groningen

In the hospital in Groningen, in the Plastic Surgery department, research is being conducted into the genetic cause of three conditions: Ledderhose’s disease, Peyronie’s disease and Dupuytren’s disease . Hereditary factors play a role, but we do not yet know which ones. More information about the research can be found on the UMC Groningen website.

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  • Dupuytren’s disease: cause, symptoms and treatment
  • Peyronie’s disease: curvature of the penis

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