Palmoplantar Psoriasis

Psoriasis is a common skin condition that causes red, itchy and scaly patches to form on the skin. Palmo-plantar psoriasis is a type of psoriasis that typically affects the palms of the hands and the soles of the feet. The majority of patients with palmo-plantar psoriasis are current or previous smokers. It can affect individuals of all ages. The disease can have flare ups and certain triggers can cause these flare ups.

Palmoplantar psoriasis is an autoimmune condition, meaning the body’s immune system causes the cells in the skin to develop too quickly. It is caused by genetic and environmental factors. The environmental triggers include:

  • Smoking
  • Friction
  • Irritants
  • Repetitive trauma
  • Stress

Patients with certain diseases are more likely to develop this condition, this includes, type 1 diabetes, thyroid disease, gluten sensitivity and streptococcal tonsillitis. 

Symptoms

  • Raised, thickened portions of the skin
  • Redness and scaling
  • Itching and burning sensations
  • Pain
  • Cracking and bleeding

May also experience,

  • Small pustules (a small blister or pimple on the skin containing pus)
  • Pitting, ridging and thickening of the nails 

Treatment

There is no cure for this condition. However, there are various ways to manage the symptoms. Managing palmoplantar psoriasis can be difficult as the flare ups are often unpredictable. It is possible to do this at home but a visit to the GP is recommended in order to get a diagnosis and rule out any similar skin conditions such as eczema. 

  1. Emollients: this is a thick, greasy barrier cream and a thin layer can be applied frequently to help moisturize the thick, scaly skin and prevent the painful cracking. Creams containing ingredients such as urea or salicylic acid help to break down scaly skin. 
  2. File the skin: filing down the skin before applying cream can help to reduce the dry, scaly parts of the skin. It is best to do this after a shower or bathing of the hands and feet as the skin will be softened. Filing can be done using an Emery board or pumice stone. 
  3. Taking daily baths with bath oils, salts and mild soaps.
  4. Applying aloe vera to the lesions may help to reduce the redness
  5. Lifestyle changes such as avoiding smoking and stress can help to reduce flare ups of the condition

A GP may prescribe topical corticosteroid or topical retinoid creams to apply to the affected area. Severe forms of this condition may require oral medications also.

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