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Palmoplantar psoriasis

Palmoplantar psoriasis can exist alone in the absence of other typical psoriatic lesions.
Red plaques are typically surmounted by a compact to micaceous scale. Fissuring may be present. Pustules, and occasionally vesicles, may be evident.
Palmoplantar psoriasis is a debilitating condition which can significantly compromise quality of life. Exacerbating factors include, as with all psoriasis, trauma.

Treatment:

  • Palmoplantar psoriasis is quite resistant to treatment.
  • Topical glucocorticoids, such as the most potent agent clobetasol 0.05 % ointment bid, are the mainstay of treatment.
  • If patients fail to respond to this, PUVA of the hands and feet is often effective.
  • Short term oral cyclosporine 2-5 mg/kg is indicated for severe involvement.
  • Methotrexate 5 mg q 12 hrs, for 3 doses, once a week is also useful in recalcitrant disease, but the use of these systemic agents though should be restricted to those patients whose quality of life is truly very seriously compromised.
palmoplantar psoriasis


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