Psoriasis may be localised to the palms and soles or part of generalised plaque psoriasis. Two common patterns are observed:. What is the treatment for palmoplantar psoriasis? Psoriasis predominantly affecting the palms and soles takes two forms:. Palmoplantar pustulosis is a chronic inflammatory skin condition. Automatically track and log every page you have viewed. Further treatment options in secondary care include low doses of oral retinoids with Psoralen combined with ultraviolet A (PUVA) or UVB phototherapy, methotrexate, ciclosporin or acitretin. Psoriasis can occur on the soles of your feet and palms of your hands. Find out what kind of psoriasis treatment works best for this painful type of psoriasis. There are two forms of psoriasis that can be seen on the palms of the hands and soles of the feet. The severe form of foot (or hand) psoriasis is called palmoplantar pustulosis.
5,7,12 While the palms and soles represent a relatively small body surface area, their involvement may lead to severe disease. A (PUVA) therapy has also been shown to be effective in the treatment of PPP, though little is known about the efficacy and safety of local NB-UVB. Pustular psoriasis is primarily seen in adults. It may be limited to certain areas of the body for example, the hands and feet. Palmoplantar pustulosis (PPP) causes pustules on the palms of the hand and soles of the feet. Generalized pustular psoriasis: The goal of treatment is to prevent infection and fluid loss, stabilize the body’s temperature and restore the skin’s chemical balance. PPP is also known as pustular psoriasis of the palms and soles because some affected persons also have psoriasis. The scaling may be so prominent that only redness and scaling is seen.
Methotrexate is the most common treatment for pustular psoriasis. Frequent use of topical therapies on the hands and feet can be impractical for most people as it makes working and daily chores difficult to perform. Hand-foot syndrome is also rarely seen in sickle-cell disease. Existing hypothesis are based on the fact that only the hands and feet are involved and posit the role of temperature differences, vascular anatomy, differences in the types of cells (rapidly dividing epidermal cells and eccrine glands). Hypothyroidism is an unusual cause of palmoplantar keratoderma, rarely reported in the literature. Acquired palmoplantar keratoderma has been associated to numerous underlying causes, such as psoriasis, lichen planus, pityriasis rubra pilaris, eczema, Reiter s syndrome, fungal infections, keratoderma climactericum, trauma, drugs, chemicals and malignancies 1 4. A 43-year-old black woman presented with a 3-month history of symmetric, diffuse and yellowish hyperkeratosis of palms and soles. A progressive worsening was seen in the last 2 months, despite treatment with topical antifungals, oral terbinafine and topical corticosteroids.
Insights Into Treating Palmoplantar Psoriasis
Some very commonly seen symptoms in this case include itchy and painful skin, and white blisters surrounded by red skin are easily visible. Palmoplantar psoriasis is another form of psoriasis that occurs on your palms and soles. Although all forms of psoriasis should be treated with equal concern, palmoplantar psoriasis affects less people than the other two. Palmoplantar pustulosis; Palmoplantar psoriasis; Pustular psoriasis. On the other hand, only palmar involvement is occasionally seen, while incidence of only sole involvement is much lower. PPP lesions are typically confined to the palms and soles, while a number of erythematous lesions with scaling sometimes appear on the trunk and/or extremities. Acral psoriasis is limited to the volar surfaces of the hands and/or feet in 81 of cases. Such silver scales are less prominent on the palms and soles. Topical calcipotriol has been shown to be effective for the treatment of limited chronic plaque form psoriasis, including the palmoplantar variant. Apremilast may be a useful oral treatment option for patients with moderate to severe palmoplantar plaque psoriasis. Palmoplantar pustular psoriasis is characterised by numerous small, sterile yellow pustules and widespread erythema localised to the palms and soles (1). This site is intended for the use of healthcare professionals only. The skin of palms and soles is unique and very different from other regions of the human body.
The various forms of PPK can be divided into hereditary forms with only skin problems, hereditary syndromes with PPK as an associated feature, and acquired forms. The more commonly seen hereditary PPKs are discussed here. Even, widespread thickened skin (keratosis) over the palms and soles. Individuals may have well defined psoriasis-like plaques or lichenoid patches (small firm lesions set very close together) on the knees and elbows.