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Palmoplantar Psoriasis

Psoriasis affecting the palms and soles, causing thick scaly plaques and painful fissures.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dermatoloji department. Book Appointment →

What is Palmoplantar Psoriasis?

Palmoplantar psoriasis presents as well-demarcated erythematous plaques with thick adherent scale on the palms and soles, often with painful fissures. It may exist alone or coexist with plaque psoriasis elsewhere on the body.

Two main subtypes are recognized: hyperkeratotic palmoplantar psoriasis with thick scaly plaques, and palmoplantar pustulosis with sterile pustules on an erythematous base. The latter is now considered a related but distinct entity.

Despite limited body surface area involvement, the functional impairment is profound, severely affecting quality of life. Smoking is a strong association, especially with palmoplantar pustulosis.

Symptoms

Thick scaly plaques on palms and soles
Painful fissures and cracks
Erythema and hyperkeratosis
Itching and burning sensation
Pustules on erythematous base (in pustular form)
Difficulty walking, gripping or working
Nail involvement (pitting, dystrophy)

Risk Factors

Smoking (especially for palmoplantar pustulosis)
Family history of psoriasis
Mechanical trauma and friction
Stress and emotional factors
Female sex (palmoplantar pustulosis)
Streptococcal infection
Certain medications (beta-blockers, lithium)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent thick scaling on palms or soles
  • Painful fissures interfering with daily activities
  • Pustules on hands or feet
  • Failure of over-the-counter moisturizers
  • Loss of work or activity restriction
  • New nail changes accompanying skin lesions

Treatment Methods

01
Topical high-potency corticosteroids under occlusion
02
Vitamin D analogues (calcipotriol) and salicylic acid keratolytics
03
Topical retinoids (tazarotene)
04
Targeted phototherapy with narrowband UVB or hand-foot PUVA
05
Systemic acitretin, methotrexate, or cyclosporine
06
Biologics (adalimumab, secukinumab, guselkumab) for refractory disease
07
Smoking cessation and stress reduction

Which Department to Visit?

You can visit our Dermatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.