Palmoplantar pustulosis

Palmoplantar pustulosis

Chris Schach

Author Bio -

Key Points
*Subtype of Palmoplantar psoriasis which typically affects the palms of the hands and/or soles of the feet
*Cause of psoriasis is unknown, but is thought to be due to functional errors in the immune system
*Consists of the formation of small yellow to brown pustules which appear in sheets

Palmoplantar pustulosis is a subtype of palmoplantar psoriasis which typically affects the palms of the hands and/or the soles of the feet. The condition presents as small, yellow to brown pustules which form in sheets. Additionally, it may be accompanied by redness, scaling, dryness and cracking of the affected area, which causes pain and limits movement. The condition is typically chronic and recurrent.

The exact cause of psoriasis is unknown, but the condition seems to arise from functional errors in the immune system. Palmoplantar pustulosis tends to be more common in persons who smoke or have smoked, but may also be hereditary. The condition typically presents in adulthood.

Differential Diagnosis (Other conditions with similar appearance)
Pityriasis rubra pilaris
Secondary Syphilis
Dyshidrotic Eczema
Tinea pedis

 

    Diagnosis
    Key Points
    *Diagnosis based on skin appearance
    *Skin biopsy may be performed to confirm diagnosis and to rule out other conditions

    Palmoplantar pustulosis is typically diagnosed based on the appearance of the affected area. A skin biopsy may be performed to confirm the diagnosis and to rule out other, similar appearing conditions.

    Treatment
    *Avoiding trauma or repetitive friction is advised
    *In mild cases, topical therapies are typically used
    *Severe cases may require more aggressive therapies

    Avoiding trauma, repetitive friction, and other stimuli which may worsen the condition is advised. In milder cases, topical therapies such as use of emollient creams, coal tar preparations, creams containing urea or salicylic acid, and topical steroids are typically used to treat the condition. Severe cases may require more aggressive therapies, such as phototherapy and systemic treatments such as acitretin and methotrexate.

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