Hormonal and physical changes, personal and family history of depression, and the stress of caring for a new baby all may contribute to the development of postpartum depression.Evidence suggests that hormonal changes may play a role. Understanding the neuroendocrinology characteristic of PPD has proven to be particularly challenging given the erratic changes to the brain and biological systems during pregnancy and postpartum. A review of exploratory studies in PPD have observed that women with PPD have more dramatic changes in HPA axis activity, however directionality of specific hormone increases or decreases remain mixed. Hormones which have been studied include estrogen, progesterone, thyroid hormone, testosterone, corticotropin releasing hormone, endorphins, and cortisol. Estrogen and progesterone levels drop back to pre-pregnancy levels within 24 hours of giving birth, and that sudden change may cause it. Aberrant steroid hormone–dependent regulation of neuronal calcium influx via extracellular matrix proteins and membrane receptors involved in responding to the cells microenvironment might be important in conferring biological risk. The use of synthetic oxytocin, a birth-inducing drug, has been linked to increased rates of postpartum depression and anxiety.Fathers, who are not undergoing profound hormonal changes, can also have postpartum depression. The cause may be distinct in males. Profound lifestyle changes that are brought about by caring for the infant are also frequently hypothesized to cause PPD. However, little evidence supports this hypothesis. Mothers who have had several previous children without experiencing PPD can nonetheless experience it with their latest child.
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. The herniation results in small bumps called piezogenic pedal papules or piezogenic papules. Though piezogenic papules are most commonly found on the heel, they can also be found on the wrist and palm.Piezogenic papules are relatively common; in one population-based study, the prevalence was found to be 76%. They occur more frequently in runners, triathletes, and individuals exposed to long periods of standing. They are also common in individuals with connective tissue disorders, especially Ehlers–Danlos syndrome. 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. See also
Skin lesion
Tennis toe
List of cutaneous conditions

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