Another picture puzzle- connect the dots

pulpitistoesWe had such a great response to our Two Peds in a Pod® visual diagnosis post that we are posting another summertime picture puzzle:

What is it? Pictured below are the toes of one of my best friend’s toddler. She is happy, has no fever, and plays nearly everyday in the neighborhood pool. The round shiny pink bumps and dots on her toes appeared yesterday morning and haven’t changed much in a day. They don’t seem to bother her very much… answer below.

It’s Swimming pool pulpitis- a fancy word for a reaction of the pulp (the meaty tip) of fingers or toes. Mostly seen on the finger tips, the pulpitis is usually caused by irritation of the fingers by the rough side of the swimming pool as kids pull themselves in and out. Kids are sometimes annoyed by the dots, but they go away on their own as soon as the kids decide to use the ladder. In this case, this little swimmer irritated her toes, not her fingers, while “monkey walking” along the side of the swimming pool in the water.

Naline Lai, MD with Julie Kardos, MD

©2013 Two Peds in a Pod®

originally posted June 2011
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  • Reply Concerned Parents August 14, 2013 at 11:30 am

    thank you for the article on toe pulpitis! I have a daughter with NS and we are on holidays abroad, those dots appeared! frightened the life out of us 🙂

  • Reply pure health garcinia cambogia April 22, 2014 at 12:42 pm

    I would have never connected the dots myself! It is such cases where your blogs really get useful. The thing does not bother the child nor does it look serious enough to warrant a visit to the doctor, yet it remains on the back of your mind.

  • Reply Nel May 31, 2015 at 9:49 pm

    Wow! Thanks so much for this post! I got all nervous upon seeing those little red dots on my 3-year old earlier this morning while I was massaging his feet. I had to google it ofcourse and fortunately I ran into this post and it makes sense now because we went swimming on Saturday.
    Whew! Thank goodness!

  • Reply Kat June 27, 2015 at 7:06 am

    Thank you so much for posting that photo of pool pulpitis. I was worried it was hand, foot and mouth but he didn’t have a fever and his didn’t look like a ‘rash’. My son, who just started summer swim lessons last week, has those exact dots on the pads of his toes, both feet.

    However, I have a question. His toes hurt him to walk and the ones on the big toes open and then begin to slightly bleed. Is there any remedy or method of pain relief for this? Thank you!

    • Reply twopedsinapod July 25, 2015 at 5:50 pm

      treat the toes like any other injured area of the body with rest good soap and water washing to prevent infection and a little TLC. Cool water/ice packs in a baggie and a little hydrocortisone (on closed areas) will also help.

  • Reply Happe mum June 28, 2015 at 7:44 pm

    My 3 years old has it and I was pretty sure it was from the pool as we are on vacation in Miami and that’s the only thing I could think of. In his case it bothers him and sometimes he says it hurts and can’t walk properly. I might just buy him plastic shoes for the pool.

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