Bilateral Painful Erythematous Nodules on the Sole

An otherwise healthy 8-year-old boy presented with erythematous and tender nodules on the soles of the feet, leading to difficulty walking (Figure, A). There was no palmar involvement. He had a past medical history of diarrhea without fever during the preceding week. Moreover, he reported repetitive thermal and mechanical trauma playing football and cycling the days before nodules were noted. Blood count, erythrocyte sedimentation rate, and C-reactive protein were normal. Serologic tests were performed to exclude Toxoplasma gondii, Francisella tularensis, Epstein-Barr virus, cytomegalovirus, and enterovirus infections.

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