Pustulosis palmaris et plantaris

A chronic skin condition affecting the palms and soles

Pustulosis palmaris et plantaris is a chronic inflammatory skin condition characterized by the presence of pustules on the palms of the hands and the soles of the feet. It is considered a variant of psoriasis and is sometimes referred to as palmoplantar pustulosis.

Clinical Presentation

Pustulosis palmaris et plantaris primarily affects the palms and soles, presenting with sterile pustules that can coalesce into larger areas of pus-filled blisters. These pustules are often accompanied by erythema (redness) and scaling. The condition can be painful and may significantly impact a patient's quality of life due to discomfort and the potential for secondary infection.

Pathophysiology

The exact cause of pustulosis palmaris et plantaris is not fully understood, but it is believed to be an autoimmune disorder. The condition is associated with an abnormal immune response that leads to the accumulation of neutrophils in the epidermis, resulting in pustule formation. Genetic factors, environmental triggers, and lifestyle factors such as smoking have been implicated in the development and exacerbation of the disease.

Diagnosis

Diagnosis of pustulosis palmaris et plantaris is primarily clinical, based on the characteristic appearance of the pustules on the palms and soles. A skin biopsy may be performed to rule out other conditions and to confirm the diagnosis by demonstrating the presence of neutrophils in the epidermis.

Treatment

Treatment of pustulosis palmaris et plantaris can be challenging and often requires a combination of therapies. Topical treatments such as corticosteroids and vitamin D analogs are commonly used to reduce inflammation and promote healing. In more severe cases, systemic treatments such as methotrexate, cyclosporine, or biologic agents may be necessary. Phototherapy is another option that can be effective for some patients.

Prognosis

The prognosis for pustulosis palmaris et plantaris varies. While some patients may experience periods of remission, others may have chronic, persistent symptoms. The condition can be difficult to manage, and ongoing treatment is often required to control symptoms and prevent flare-ups.

Related Pages

• Psoriasis
• Autoimmune disease
• Dermatology
• Skin biopsy