Continuous phenobarbital treatment and palmoplantar fibromatosis

Palmoplantar disease is a hyperproliferative disorder with dystrophic nodules in the superficial plantar and palmar fascia. It can be associated with other pathologies such as Lapeyronie’s desease, diabetes, alcohol dependence or continuous phenobarbital treatment. We report the rare case of a pathological association made of Ledderhose's disease, Dupuytren's disease and barbiturates in an epileptic patient. Conservative treatment well conducted for more than 6 months is not satisfactory. A complete fasciectomy is performed with good functional results without recurrence. The association between epilepsy and palmoplantar fibromatosis is extremely rare. The role of barbiturates in mediating tissue growth factors would in theory explain this hyperproliferative disorder of the plantar fascia. The association between fibromatosis and cell growth mediators evokes new approaches aimed at modulating these cells for better therapeutic control.