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Palmoplantar Pustulosis

People with cracking heels or fissures on their feet or palm may be diagnosed with palmoplantar pustulosis. It may involve a palm or sole, but it can also affect simultaneously both hands and feet. The pustules undergo progressive stages, and fissures can go deep as 2 to 5 mm.  In an advanced stage, the pustules develop into red crusty macule or spots. The infection runs in families but seldom occur in young children. People who have this skin condition may also have psoriasis, and in this case they appear in the form of pustular psoriasis. They eventually turn brown and scaly.

Fortunately, this skin disorder is sterile or not contagious; but when they do occur they come and disappear in waves. There is no known trigger so there can be no definite precautions to follow except avoiding tight foot wear and skin friction. Palmoplantar pustulosis varies in severity and often persists for years. Patients usually complain of backpains, crumpled toes, and bizarre looking hands.  

Palmoplantar Ppustulosis Treatment

For skin treatment, doctors will prescribe soak for hands and feet. The hands and feet should be immersed for 15 minutes immersed in lukewarm water containing 8 methoxypsoralen.  Exposure to UVA phototherapy is also effective.  Burns may occur with frequent exposure to UVA, but this is a small sacrifice if one wants to be relieved of the itch.  Nightly topical applications of creams with glucocorticoids, coal tar, and dithranol can control the infection but will not prevent future recurrences.  Palmoplantar pustulosis is a stubborn condition that will require methorexate.  

If you have the condition you can ease the severity or contain the infection by wearing comfortable footwear made from natural fibers.  As much as possible protect your soles and palms from friction and minor injuries. When washing the affected areas, use bath oil instead of harsh soaps.  Always cover the deep skin breaks with waterproof dressing to prevent further infections. Patients with palmoplantar pustulosis are advised refrain from walking long periods to prevent further skin lesions.  If the palms are involved, all manual labor should be avoided.

Other skin care tips and treatments for palmoplantar pustulosis, like the application of salicylic acid is encouraged to get rid of the flaky skin.  The patient’s feet should always be well lubricated to prevent more fissures. White wax should be applied liberally to lock in moisture. Drug treatment of strong topical steroids used be used with occlusion (or covering) for a limited time only as these lose their efficacy when used for too long.  

There are emerging research results that show that palmoplantar pustulosis is not just a skin disease but a systematic disorder associated with bone lesions, diabetes mellitus or Crohn’s disease. The pustular eruptions on the soles and the palm are symptomatic of the diseases. Once the main causes are cured, the skin disease can go away. This has given much hope to sufferers who have to curtail some fulfilling activities in their lives.

 
   
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