Key takeaways

  • Palmoplantar psoriasis is a condition affecting the palms and soles. It causes thickened, discolored skin that can make everyday activities difficult.
  • The causes of palmoplantar psoriasis are not fully understood, but are believed to involve a combination of genetic and environmental factors that trigger an autoimmune response.
  • While there is no cure for palmoplantar psoriasis, various treatments and home remedies, such as medications, light therapy, and moisturizers, can help manage the symptoms and improve quality of life.

Psoriasis affects 2% to 5% of the population, and 3% to 4% of people with psoriasis have palmoplantar psoriasis. Palmoplantar psoriasis can occur at any age. A related condition, palmoplantar pustulosis, usually starts between the ages of 20 and 60 years.

Palmoplantar psoriasis affects the palms and soles and is a subtype of both plaque psoriasis and pustular psoriasis.

A person may not have symptoms all the time. Often, they will experience periods of remission and then a flare-up. Certain triggers can cause a flare-up.

This article discusses how to recognize palmoplantar psoriasis, what causes it, how to treat it, and when to contact a healthcare professional.

Palmoplantar psoriasis can occur as part of general plaque psoriasis or only affect the palms of the hands and the soles of the feet.

Symptoms include:

  • well-defined areas of raised, thickened skin
  • scaling
  • an itching and burning sensation
  • pain
  • cracking and bleeding
  • symmetrical patterns of lesions on the hands and feet

There may also be:

  • small pustules
  • skin changes on the rest of the body, due to general plaque psoriasis
  • pitting, ridging, and thickening of the nails, also due to general plaque psoriasis

Palmoplantar psoriasis can make it difficult to carry out everyday activities, such as walking and using the hands.

If someone has lesions on the hands, it can be difficult to cover them, potentially leading to embarrassment and social anxiety.

Palmoplantar psoriasis on different skin tones

Pustular psoriasis appears differently on different skin tones.

  • On light skin: The skin around pustules may be pink or red.
  • On medium skin: Inflamed skin may look dark pink.
  • On dark skin: The pustules may be purple, pink, or light brown. The surrounding skin may be darker than the person’s normal skin tone or purplish.

The following images show how palmoplantar psoriasis may appear on the skin.

To diagnose palmoplantar psoriasis, a healthcare professional will examine the symptoms and ask about a person’s medical history.

They may also perform a biopsy, which involves taking a small skin sample and sending it to a lab to be examined under a microscope. This can help rule out other inflammatory skin conditions, such as eczema, contact dermatitis, or a fungal infection.

Other tests may also be necessary, although healthcare professionals can often diagnose psoriasis based on skin appearance alone.

Experts do not know exactly what causes palmoplantar psoriasis. However, it is likely caused by a combination of genetic and environmental factors.

Palmoplantar psoriasis, like other forms of psoriasis, is an autoimmune condition. A problem with the immune system causes skin cells to develop and multiply too quickly, thickening the skin.

Environmental risk factors, lifestyle choices, and other health conditions may increase the likelihood of palmoplantar psoriasis. Risk factors include:

  • household work
  • farm work
  • manual labor
  • exposure to chemical and physical irritants, such as detergents
  • exposure to allergens
  • smoking
  • friction
  • injury
  • thyroid disease
  • arthritis of the anterior thorax
  • stress

Research from 2021 indicates that smoking may increase the risk of palmoplantar psoriasis. Most people with the condition either currently smoke or have previously smoked.

According to the National Psoriasis Foundation (NPF), individuals with psoriasis often have a higher risk of developing:

People with palmoplantar psoriasis and other types of psoriasis also have an increased risk of psoriatic arthritis, which affects the joints.

There is little information about treatment specifically for palmoplantar psoriasis.

However, the following options may relieve symptoms, either alone or in combination:

A person may have to work with a healthcare professional and try several treatments to find the most suitable one.

Some home remedies may help reduce pain and discomfort in people with palmoplantar psoriasis.

Bathing and soaking

Bathing can alleviate palmoplantar psoriasis symptoms, but it is important to use a suitable water temperature and gentle products.

  1. Soak the hands and feet in lukewarm water.
  2. Add a soothing natural substance, such as oatmeal or Dead Sea salt.
  3. Use mild soaps and bath oils that are free from added colors and fragrance.
  4. Blot the skin dry after soaking with a soft, clean towel to avoid irritation.
  5. Apply moisturizer to the damp skin. Do not let the skin dry out before applying moisturizer.

Humidity and moisture

To reduce skin dryness, a person can use a humidifier and moisturize the skin several times daily, especially in dry weather.

Moisturizers with naturally soothing, anti-inflammatory properties, such as aloe vera, may relieve symptoms.

A doctor, nurse, or pharmacist can recommend suitable products for moisturizing.

Psoriasis is an autoimmune condition, so it is not contagious. People cannot contract it by coming into contact with the affected skin of a person with the condition.

However, if someone is experiencing symptoms and does not yet have a diagnosis of psoriasis, they should talk with a healthcare professional. Although rare, some contagious conditions, such as secondary syphilis, may mimic the symptoms of palmoplantar psoriasis.

Palmoplantar psoriasis can be disabling because it affects the hands or feet. With proper medical documentation, a person with psoriasis may qualify for social security disability payments.

Palmoplantar psoriasis tends to be a long-term condition. Currently, there is no cure, but treatment can help manage symptoms.

Palmoplantar psoriasis causes inflammation and pustules on the palms and soles. It can be a disabling condition due to the location of the inflammation.

Palmoplantar psoriasis is an autoimmune condition that is likely to be inherited through genes. However, lifestyle factors, such as smoking, and environmental factors, such as irritants, often increase a person’s risk.

A person may need to try various treatments before finding those that improve their symptoms. Healthcare professionals may recommend topical and systemic medications and light therapy. Home remedies may also help reduce discomfort.

Psoriasis is a lifelong condition without a cure. However, if a person can identify their triggers and the treatments that work, they can reduce the impact the condition has on their quality of life.