Pustulosis palmaris et plantaris is a chronic recurrent pustular dermatosis (that is, a pustulosis or pustular psoriasis) localized on the palms and soles only, characterized histologically by intraepidermal pustules filled with neutrophils.[2]: 411, 628 [3]: 204 It can occur as part of the SAPHO syndrome.[4]
Pustulosis palmaris et plantaris | |
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Other names | Pustulosis of palms and soles,[1] Palmoplantar pustulosis, Persistent palmoplantar pustulosis, Pustular psoriasis of the Barber type, and Pustular psoriasis of the extremities |
Pustulosis palmaris et plantaris | |
Specialty | Dermatology |
Differential diagnosis | SAPHO syndrome |
Systematic reviews show evidence to support the use of systemic retinoids alone and in combination with photochemotherapy to improve symptoms of chronic palmoplantar pustulosis, with a combination more effective than one alone. There is also evidence to support topical steroids under hydrocolloid occlusion dressings, low dose ciclosporin, tetracyclines, and Grenz-Ray Therapy. There is no evidence to support the use of hydroxyurea in chronic palmoplantar pustulosis.[5]
Treatment with guselkumab, an anti–interleukin 23 monoclonal antibody has shown a decrease in the size of the area affected and severity.[6]