Palmoplantar Psoriasis – Conditions

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Overview

Psoriasis that affects the palms of the hands and the soles of the feet is known as palmoplantar psoriasis. It is a long-term illness that may persist for years. This autoimmune illness may flare up when certain triggers are present. It is not a contagious disease.

It may appear almost anywhere on the body and it can be very painful.

Psoriasis affects between 2 and 5% of the population, with palmoplantar psoriasis accounting for 3 to 4% of individuals with the disease. Psoriasis may appear on the palms and soles of the feet at any age.

It’s conceivable that a person’s symptoms are not there all of the time. They often go through phases of remission followed by flare-ups. A flare-up may be brought on by a number of causes.

Causes

Palmoplantar psoriasis, like all other types of psoriasis, affects the hands and feet. Skin cells grow at an abnormally rapid rate due to an issue with the immune system.

It is a kind of psoriasis that affects the skin on the palms of the hands and the soles of the feet, with plaques appearing on the skin.

Although no one knows precisely what causes palmoplantar psoriasis, it is thought to be a result of a mix of hereditary and environmental factors in certain individuals.

An issue with certain sweat glands may also be a contributing factor. The vast majority of individuals with this condition are current or past smokers. An inflammatory response in the sweat glands is thought to be triggered by activated nicotine receptors in this illness process. Thyroid illness, smoking, and anterior thoracic arthritis have all been associated with palmoplantar pustulosis in addition to other factors.

The hands and feet are more sensitive than the rest of the body to environmental and chemical stimuli. As a consequence, the illness may continue to develop and worsen in these areas. Farm work, as well as home labor, exposes workers to chemical and physical irritants, such as detergents, and allergies.

Symptoms

Palmoplantar psoriasis may be a component of larger plaque psoriasis or affect just the palms of the hands and soles of the feet.

Among the signs and symptoms are:

·         Redness and scaling with an itching and burning

·         Feeling of cracking

·         Bleeding

·         Thicker skin

There’s also the possibility of body pitting, ridging, and thickening of the nails.

The patterns may be symmetrical, with the same pattern on both hands, for example.

With palmoplantar psoriasis, even simple tasks such as walking may be difficult to do without assistance. Because of the position of the symptoms, it is more difficult to keep the lesions clean and to conceal them. This may cause shame and social anxiety in certain people.

Diagnosis

A comprehensive history and physical examination, as well as an investigation of triggers and exposures, are required in order to make a proper diagnosis. To rule out the presence of scaly erythematous eruption, a KOH prep should be done. A biopsy is often required because palmoplantar psoriasis may be difficult to differentiate from eczematous hand dermatitides and to rule out the presence of other conditions. In order to diagnose the illness, the doctor will examine the patient’s symptoms and inquire about their medical history.

The doctor may take a tiny skin sample or biopsy as it aids in ruling out other skin inflammatory diseases such as eczema, contact dermatitis, or a fungal infection, among other things.

Often, a doctor may diagnose psoriasis based only on the look of the skin.

Studies in the laboratory may reveal increased levels of c-reactive protein (CRP) and uric acid, both of which are raised in the pustular form of the disease.

During a psoriasis flare, a doctor may prescribe medicine to alleviate the pain and suffering.

Treatment

There is little data available regarding the therapy of palmoplantar psoriasis in particular. Although there is no cure, therapy may assist to manage the symptoms.

However, alternatives that may be effective in alleviating symptoms typically include one or more of the following, either alone or in combination:

·         Topical medication.

·         Systemic medicine, which has an impact on how the body functions

·         Treatments using light therapy and biologics

It may be necessary for a person to collaborate with their health-care practitioner and experiment with a variety of therapies before finding one that works.

Medication: Corticosteroids are considered to be first line therapy.

Light Therapy: It is the second line therapy. Exposure to UVB and UVA radiation in its natural forms may aid in slowing the rate at which skin cells reproduce and develop. The doctor may suggest one or more of the following:

Starting with 5 to 10 minutes in the sun each day, you may gradually increase your exposure.

·         If the reaction is positive, the exposure period should be increased by 30 seconds each day.

·         The individual should use sunscreen on any parts of the skin that are not affected by psoriasis.

A therapy called PUVA may be of assistance. This mixes natural light exposure with a medicine to produce a photosensitive reaction.

Systematic treatment: these therapies have an impact on the whole body. Psoriasis occurs when the immune system does not function correctly, causing skin cells to proliferate at an excessive rate. This may be avoided with the assistance of a systemic mediation.

Biologics: These are targeted treatments that have the potential to alter the immunological response of the body. It is possible that they will assist in controlling the symptoms when other therapies have failed to do so.

Some of them, on the other hand, may have serious adverse effects. A doctor will be required to keep track of the individual’s development.

The following are examples of biologic drugs:

  • Interleukin antagonist
  • Phosphodiesterase 4 inhibitors

When to see a doctor

Consult your doctor if you experience any of the symptoms listed below: Swelling, discomfort, or stiffness in one or more joints, often the fingers or toes. A burning sensation or soreness in the lower back, foot, or ankles, when you touch the joints.

Because hereditary factors are believed to have a role in the development of psoriasis, it may be difficult to avoid the disease. However, it can be prevented with the following measures that may be beneficial: regulating one’s body weight, quitting smoking e, stress management and alcohol use restrictions. Finding out what causes them to flare up may assist you prevent triggering the flare up in the first place.