Palmoplantar Psoriasis, Palmo-plantar Psoriasis

Palmoplantar psoriasis is a chronic, recurring condition that affects the palms of hands
and soles of feet. It looks similar to other types of skin conditions, such as hand dermatitis,
but the appearance of psoriasis lesions elsewhere on the body is an indicator of
psoriasis. It varies in severity, and may limit a person’s ability to complete their daily
activities. It most often affects adults, and is sometimes hereditary.

Palmoplantar psoriasis is characterized by a few different symptoms:

• The appearance of red patches of skin topped with scales typical of psoriasis on
the palms and elsewhere on the body
• Thickening and scaling of the skin accompanied with the formation of deep, painful
fissures on the palms and soles
• Palmoplantar pustulosis - the appearance of deep, yellowish pustules

PalmoPlantar Pustulosis

Although rare, Pustular Psoriasis is a very serious condition which affects the body both
internally and externally. Palmoplantar psoriasis is a type of Localized pustular psoriasis
that affects the palms of hands and soles of feet. There are two types of Localized
Pustular Psoriasis: Acropustulosis, which occurs only on the tips of the fingers, and
Palmo-plantar pustulosis, which only occurs on the palms of hands and/or the soles of
feet.

In general, Palmo-Plantar Pustulosis occurs in people between 20 and 60 years old, and
may be triggered by infection and/or stress. It has also been found to affect females more
than males. As with Generalized Pustular Psoriasis, Palmo-Plantar Pustulosis occurs in a
cyclical pattern, with new pustules occurring after a period of low-to-no activity.

Symptoms and Signs of Palmoplantar Psoriasis

The "fleshy" areas of the hands and feet (base of thumb and/or sides of heels) develop
large, yellowish pustules - about the size of a pencil eraser, or .5 centimeters. These
Pustules have a studded pattern over reddened patches of skin, and contain non-
infectious pus (white blood cells). Throughout the next 7 to 14 days, the Pustule will
become smaller, lose it's yellowish color, and become topped with a brown scale of skin.
Usually, the disease becomes much less active for a time after peeling.

Palmoplantar pustulosis had been found to occur more frequently in people who smoke
or used to some tobacco. The causes of flare-ups are not known, but pressure and
rubbing will make it worse. The effects on overall health are small, but it can be very
uncomfortable and painful.

How is Palmo-Plantar Pustulosis treated?

Palmo-Plantar Pustulosis is stubborn to treat, but the symptoms can be controlled.

Although it often affects smokers, quitting smoking does not always help clear the disease.
Topical treatments, such as corticosteroids, are usually prescribed first. PUVA, acitretin
(Soriatane), methotrexate or cyclosporine (Neoral) sometimes must be used to clear this
form. Combination treatment with PUVA and Soriatane (called RePUVA) may also be
effective. No one treatment will work for everyone and most people will have to try several
types of treatment in order to find one that works.

Acrodermatitis

Acrodermatitis is a form of Palmo-Plantar Pustulosis which is characterized by painful,

potentially disabling, skin lesions on the tips of fingers and sometimes the tips of the toes.
The nails may become deformed, and this type of Palmo-Plantar Pustulosis can change
and damage the bone in the affected area.

Treatment of Palmoplantar psoriasis

Acropustulosis occasionally starts after the skin is injured or infected. This form has
traditionally been hard to treat. Tar preparations under occlusion help some patients. Oral
retinoid drugs, such as acitretin (Soriatane), may help clear the lesions and restore the
nails. PUVA may also be used.

Related Links

Pustular Psoriasis
Natural Psoriasis Treatments
The Dead Sea and Psoriasis Treatments
Home Psoriasis Treatments