Palmoplantar Keratoderma is a rare genetic disorder, resulting in a chronic inflammatory skin condition. It is widely considered to be a variation of Psoriasis, but one which predominantly affects the palms and soles. It takes two forms, the first being scaly areas typical of psoriasis elsewhere on the body, and a more generalised thickening and scaling – known as the keratoderma. Symptoms include red scaly areas on the central palm or weight bearing areas of the soles, sometimes causing the painful cracking and fissuring of the skin. This can restrict the use of hands or walking.
1.5% of the general UK population have psoriasis. A proportion of these patients will have psoriasis involving the feet and hands which can, in some, be quite resistant to treatment.
Classical skin damage from Psoriasis can be treated with a vitamin D ointment, but in palm and sole psoriasis both thickening and inflammation of the skin are usually present. This may require separate treatments, as particularly think skin usually needs to be treated with a keratolytic agent such as 2% salicylic acid ointment BP. This can be alternated morning and evening with a topical steroid.
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