Psoriasis predominantly affecting the palms and soles takes two forms:. It is considered by some to be a variation of psoriasis and occurs in patients with other types of psoriasis. In palm and sole psoriasis, both hyperkeratosis and inflammation are usually present and may require separate treatments:Hyperkeratosis usually needs to be treated with a keratolytic agent such as 2 salicylic acid ointment BP. Reiter’s disease – gross palmar and plantar lesions may occur (keratoderma blennorrhagica) which are histologically indistinguishable from psoriasis. Palmoplantar pustulosis is a chronic pustular condition affecting the palms and soles. Palmoplantar pustulosis presents as crops of sterile pustules occurring on one or both hands and/or feet. There have been several theories. Palmoplantar psoriasis is a severe cracking, peeling with pus filled blisters on the skin. Instead of inflamed and scaly patches, there are weeping, cracked lesions that can look like masses of tiny yellow blisters. Our research shows that Psoriasis-Ltd III gives the best results for this type of psoriasis.
3,5,6,7 PPP lesions are frequently associated with psoriatic plaques elsewhere, but can occur in isolation. 5,8 In the absence of generalized psoriasis, PPP may present similarly to eczematous forms of dermatitis, such as irritant and/or allergic contact dermatitis, dyshidrotic eczema, atopic dermatitis, mycosis fungoides, tinea infections, and palmoplantar keratoderma, making diagnosis difficult. 5,7,12 While the palms and soles represent a relatively small body surface area, their involvement may lead to severe disease. 26 Efficacy of NB-UVB and PUVA have been compared in plaque-type psoriasis and have less disparity in clinical efficacy, a result that may be explained by lower penetration of NB-UVB compared to PUVA through the thickened stratum corneum of palmoplantar skin. Resistant palmoplantar lesions in patients of psoriasis: evaluation of the causes and comparison of the frequency of delayed-type hypersensitivity in patients without palm and sole lesions. Resistant palmoplantar lesions in patients of psoriasis: evaluation of the causes and comparison of the frequency of delayed-type hypersensitivity in patients without palm and sole lesions. There was a direct relationship between the increase in the prevalence of dermatitis and the duration of psoriasis. Incidence of palmoplantar psoriasis was found to be highest among all morphological forms of psoriasis. The characteristic lesions consist of red, scaly, well demarcated plaques mainly over extensors and scalp. Our study is first of its type done in South India to find the incidence of palmoplantar psoriasis and compare its incidence with other forms. Involvement of both palms and soles was more common than either of them alone.
Palmoplantar pustulosis (PPP) causes pustules on the palms of the hand and soles of the feet. Read about an NPF-backed researcher and the genetic clues she found about pustular psoriasis. Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin. There are five main types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic. Pustular psoriasis can be localized, commonly to the hands and feet (palmoplantar pustulosis), or generalized with widespread patches occurring randomly on any part of the body. Palmoplantar pustulosis (PPP) is a chronic inflammatory condition characterized by crops of sterile pustules on the palms and soles that erupt repeatedly over time (). Symptoms of pruritus, burning sensations, or pain are often present.
Insights Into Treating Palmoplantar Psoriasis
This does not mean there is infection present. PPP is normally recognisable by large yellow pustules up to 5mm in diameter in fleshy areas of hands and feet, such as the base of the thumb and the sides of the heels. Acrodermatitis continua of Hallopeau is another rare type of palmar-plantar pustular psoriasis, characterised by skin lesions on the ends of the fingers and sometimes on the toes. 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. Psoriasis lesions can be uncomfortable wherever they occur, but they may be especially difficult to endure on the soles of your feet. The severe form of foot (or hand) psoriasis is called palmoplantar pustulosis. The diagnosis of psoriasis is clinical, and the type of psoriasis present affects the physical examination findings. Psoriatic arthritis: Affects approximately 10-30 of those with skin symptoms; usually in the hands and feet and, occasionally, the large joints. Vesicular palmoplantar eczema is a term used to describe a group of diseases characterized by vesiculobullous eruption involving mainly the hands and feet. Pompholyx ( blister or bubble in Greek) may be further subdivided into vesicular and bullous forms, in which patients present with acute severe eruptions of blisters over their palms and, less commonly, the soles. Despite the wide range of clinical presentations, all 4 types of vesicular palmoplantar eczema are histologically characterized by features of dermatitis, such as spongiosis and exocytosis. People with pustular psoriasis have clearly defined, raised bumps on the skin that are filled with pus (pustules). Although pus is often a sign of infection, there is no evidence that infection plays any role in pustular psoriasis. It is usually subacute or chronic, and people with this type do not usually have symptoms aside from the skin symptoms. Pustules may be localized to the palms and soles (palmoplantar pustulosis) or to the fingertips and nails (acrodermatitis continua of Hallopeau). Inverse psoriasis is found in the armpits, groin, under the breasts, and in other skin folds around the genitals and the buttocks. This type of psoriasis appears as bright-red lesions that are smooth and shiny. Palmoplantar Pustulosis This is a type of psoriasis that causes pustules on the palms of the hands and soles of the feet.
Psoriasis Types: Pustular
Guttate psoriasis consists of drop-like lesions, usually with a sudden onset and commonly seen after a streptococcal pharyngitis infection and more commonly seen in children and young adults. Three types of pustular psoriasis exist: von Zumbusch, palmoplantar pustulosis, and acropustulosis (acrodermatitis continua of Hallopeau). Palmoplantar pustulosis develops as multiple sterile pustules on the palms and soles that eventually turn brown, peel and crust over with repeated episodes occurring. There is usually asymmetrical joint involvement and patients may have only a few joints (oligoarthritis) involved. Even, widespread thickened skin (keratosis) over the palms and soles. Diffuse epidermolytic PPK is the most common type of hereditary PPK. Individuals may have well defined psoriasis-like plaques or lichenoid patches (small firm lesions set very close together) on the knees and elbows. Topical steroids can be considered, with or without keratolytics, in conditions where there is an inflammatory component. There was no correlation between the clinical type of psoriasis and patch-test positivity. Also, psoriasis patients with palm and sole lesions tended to have higher rates of contact hypersensitivity than patients without lesions on their palms and soles. In addition to exhibiting plaque-type lesions, this variant of psoriasis can also include fissuring, crusting, erythema, and recurrent painful pustules. At present, a combination of topical psoralen photochemotherapy and systemic retinoids is frequently used. Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice.