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Palmoplantar Psoriasis

Alyssa Miceli, DO and Jenifer R. Lloyd, DO, FAAD Reviewed 06/2019
 


BASICS

DESCRIPTION

A variant of psoriasis that characteristically affects the skin of the palms and soles. It is chronic and inflammatory in nature, with hyperkeratotic, pustular, or mixed morphologies...

DIAGNOSIS

Clinical diagnosis based on history and physical exam 

HISTORY

Symptoms may include: 
  • Itching

  • Pain

  • Fissuring

  • Persistence of flares

  • Spontaneous remissions

  • Exacerbation by seasonal changes, household ...

TREATMENT

  • Limited data on treatment: Patients have historically been excluded from clinical trials of psoriasis because <10% of the BSA is affected.

  • No standardized treatment exists for patients wit...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

It is difficult to monitor disease progression and response to treatment given the paucity of standardized evaluation tools specific for palmoplantar psoriasis. 

PATIENT EDUCATION

REFERENCES

1
Farley E, Masrour S, McKey J, et al. Palmoplantar psoriasis: a phenotypical and clinical review with introduction of a new quality-of-life assessment tool. J Am Acad Dermatol.  2009;6...

ADDITIONAL READING

SEE ALSO

Psoriasis 

CODES

ICD10

  • L40.3 Pustulosis palmaris et plantaris

  • L40.8 Other psoriasis

ICD9

696.1 Other psoriasis 

SNOMED

  • 27520001 Pustular psoriasis of the palms AND/OR soles

  • 200970002 Psoriasis palmaris (disorder)

  • 200971...

CLINICAL PEARLS

  • Palmoplantar psoriasis is a chronic and difficult-to-treat type of psoriasis with significant morbidity.

  • It remains controversial if PPP is associated with palmoplantar psoriasis or is ...

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