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Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Psoriasis of the palms and soles

How does psoriasis affect the palms and soles?

Psoriasis may predominantly affect the palms and soles in various ways:

Plantar psoriasis Palmar psoriasis Palmar psoriasis
Palmoplantar psoriasis

More images of palmoplantar psoriasis ...

Clinical features

Palms and soles affected by psoriasis tend to be partially or completely red, dry and thickened, often with deep painful cracks (fissures). It can be quite hard to differentiate from hand dermatitis and other forms of keratoderma, but signs of psoriasis elsewhere may help make a diagnosis.

Palmoplantar pustulosis is considered a distinct entity in which there are clusters of pustules on the palms and/or soles, but about 10-20% of those affected have psoriasis on other sites of the body.

Palmoplantar psoriasis tends to be a chronic recurrent condition.

What is the treatment for palmoplantar psoriasis?

Mild psoriasis of the palms and soles may be treated with topical treatments:

Calcipotriol ointment is not very successful for palmoplantar psoriasis and may cause an irritant dermatitis on the face if a treated area inadvertently touches it. Dithranol is too messy for routine use on hands and feet.

More severe palmoplantar psoriasis usually requires phototherapy or systemic agents, most often:

Biologics are also sometimes prescribed for severe palmoplantar psoriasis.

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Author: Dr Amy Stanway, Department of Dermatology, Waikato Hospital

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