Psoriasis – Palmoplantar Pustulosis

Palmoplantar Pustulosis is a type of Psoriasis in which patients develop pustular psoriatic plaques on the palms and soles and I occasionally encounter this skin disease in both my The Woodlands dermatology and Conroe dermatology clinics.  Palmoplantar Pustulosis usually occurs in adults and there is a strong correlation with patients who are smokers.  Patients who continue to smoke have a very difficult time treating this disease as it becomes recalcitrant to most treatment modalities.  The palms and soles are affected due to repeated trauma from daily activities such as walking and using the hands.  Thus, it is important to protect the hands and feet by relieving pressure and covering them in bland emollients. Ultrapotent topical steroids, topical retinoids, coal tar are all used to treat Palmoplantar Pustulosis.  Some patients may require PUVA light therapy and systemic medications such as Methotrexate and Cyclosporin.