Palmar-plantar psoriasis: pictures, symptoms, treatment

Palmar-plantar psoriasis affects the palms of the hands and soles of the feet and the disease is a pathological autoimmune condition.

Psoriasis on the palms and soles, along with the localization process on the scalp is one of the most common forms of the disease. It accounts for about 14% of cases a pathological condition of the skin.

The reasons for the development of the disease

Although Palmar-plantar psoriasis is not peculiar to the reference to age in the period of 15-35 years has been the highest frequency of developing the disease. There is a link with ethnicity. It is reported that in individuals of Caucasian nationality over the age of 50 years significantly increases the risk of developing this disease.

The exact cause of pathological conditions is not fully understood and is still considered that the disease is an autoimmune process. In normal operation, the immunity a person receives protection against a variety of foreign agents: viruses, allergens, protozoa and other microorganisms.

When psoriasis occurs a failure in the body, then the immune system starts to produce aggressive substances against its own cells and tissues. The excessive number of T-lymphocytes (key cells of the immune system) and macrophages leads to the development of inflammatory response and excessive proliferation of skin cells, causing the observed typical symptoms and the appearance of hyperkeratosis.

Attention! Hyperkeratosis is an excessive thickening of the epidermis — the outer layer of the skin.

Some studies indicate a minor role of the factor of heredity. For example, about 10% of the population inherit the genes associated with psoriasis and only 3% of them develop the disease. Such statistics suggest the presence of other, more fundamental causes of the disease.

Additional risk factors are:

• Stress and emotional lability (sensitivity).
• Smoking and taking drugs.
• Background diseases that affect the immune system.
• Infections, frequent injuries and cuts on the palms and soles.

In the 2006 study, it was stated about the relationship of dermatological diseases with cardiovascular diseases and other conditions: hypertension, diabetes and hyperlipidemia.

The results of experiments to the end were not clear. For a full understanding of all processes, the study of the topic continues and more research is needed.

Triggers of the disease (factors that influence pathology, but not causing it directly) can be the following:

• Sunburn;
• Insect bites;
• The impact of allergens.
• Common bacterial infections such as pneumonia or a sore throat;
• Viral diseases, including HIV infection;
• Inflammatory condition of varying severity: bronchitis, nasopharyngitis;
• Severe alcohol intoxication;
• Obesity.

Diagnosis of Palmar-plantar psoriasis

Despite the rapid development of modern medicine, is still the establishment of psoriasis on palms it is possible by visual inspection of the skin by a physician without special equipment. A physical examination is based on "psoriatic triad", whose manifestations were observed with a light scraping of the scales from the affected parts of the body.

The doctor pays attention to the history of the disease, as some constantly take medications can be triggers of the disease:

• Indomethacin and other nonsteroidal anti-inflammatory drugs (NSAIDs);
• Lithium and antimalarial drugs;
• Abrupt withdrawal of corticosteroids;
• Taking penicillin, hydroxychloroquine.

In severe cases, a comprehensive examination, which includes laboratory blood tests and ultrasound scanning, as well as the exclusion of fungal infection using mycological diagnosis. The indication of biopsy of a questionable lesion of the skin.

Symptoms and first signs of Palmar-plantar psoriasis

Among the main types of the disease there are five variations. Thus in 90% of cases observed visual characteristic clinical picture.

Looks like Palmar-plantar psoriasis? The patient on the palms and soles defined psoriatic plaques, red scaly patches on thickened skin that is prone to peeling. In centers the person feels itching, fever and pain of different intensity; in some cases the skin is cracked and bleed.

To be an influence on the formation of the nails:

• In the nail plates may appear defects, holes;
• The nail thickens and discolors;
• Changing his form.

Palmar-plantar disease occurs as part of the overall process, but is limited only by the skin of the palms and feet. Psoriasis of the soles makes it difficult to walk and wearing shoes. Damage to the hands can not only prevent the execution of any work, but also impose a negative impact on relationships with people. Ordinary situation, like a welcome hand, can be awkward, leading to embarrassment and social anxiety of man until the development of social phobia.

A distinctive feature of this form of the disease is the presence of the varieties of process that can be referred to by the following terms:

• Palmar-plantar pustular psoriasis Barber;
• Purulent psoriasis;
• Pustular dermatitis.

Listed disorder of the skin causes the formation of clusters (of clusters) of various pustules in region of plaques. Generally, such rashes are very similar to normal pimples. It should be noted that such kind of disease is endures easy methods to treat and often requires an integrated approach to therapy.

Please note! Pustular psoriasis of the palms and soles require treatment with antibacterial drugs when joining a bacterial infection.

Stage Palmar-plantar psoriasis

As with all forms of the pathological process, Palmar-plantar localization is characterized by three clinical stages:

1. The initial stage. The appearance of lesions on the hands and feet. The plaques have a characteristic red hue, there may be purulent whitish inclusions; the patient worries intense itching. The lesions coalesce into large pockets. Their number depends on the individual characteristics of the disease.
2. The stage of stabilization. The condition does not progress, the new pathological elements are not formed, but the old is still intact. Itching gradually subsides, and the color of plaque becomes less bright.
3. The final stage. Accompanied by regression of elements, pruritus is absent. The treatment becomes that support either shuts down completely; offers recommendations for the preservation of remission and prevention of relapse.

In some cases, the disease is classified according to the elements of the rash:

• Normal form — a typical manifestation of the skin;
• Horny form is accompanied by hyperkeratosis and the typical red spots little, or they do not exist;
• Form Of Barbera.

Treatments

Palmar — plantar psoriasis is a chronic disease, which may appear repeatedly, regardless of treatment. However, there are therapies that can achieve a reduction in time of an exacerbation and prolongation of remission period.

The main treatment is to attempt to prevent the rapid growth of the cellular elements, which lead to the development of plaques is conducted anti-inflammatory therapy. An alternative technique provides immediate removal of scales.

Because the skin on the palms and soles thickened even in healthy people, treatment of this localization often involves a combination of techniques and a more aggressive effect on the lesions.

First psoriasis of the palms and soles is assigned to local treatment in the form of gels, ointments and creams:

• Vitamin D analogs;
• Ointments based on corticosteroids;
• Retinoids;
• Anthralin;
• Special resin;
• Salicylic acid;
• Moisturizer to reduce swelling and relieve inflammation.

Common side effects are irritation, drying and thinning of the skin. Extras can be phototherapy:

• Natural ultraviolet radiation from the sun;
• Artificial ultraviolet radiation by means of special apparatus;
• Excimer laser;
• Photochemotherapy.

It is important to know!Very important for a smooth transition to a natural phototherapy. It is recommended to start with 5-10 minutes of direct sunlight a day. In the future, you can gradually increase exposure time by 30 seconds per day.

Drugs for the treatment of Palmar-plantar psoriasis

Palmar-plantar psoriasis treatments include oral medications in more severe form of the disease:

• Methotrexate;
• Retinoids;
• Cyclosporine;
• Biological agents that reduce the activity of the immune system;
• Thioguanine;
• Hydroxyurea.

The most common side effect of these drugs are problems with the gastrointestinal tract.

The disease and prevention

Severe course of the disease to a certain extent, can affect the development of serious conditions that threaten the health and life of the patient is a 58% increased risk of myocardial infarction and 43% a stroke. The major immediate complications of psoriasis of the palms and soles is psoriatic arthritis and nail dystrophy.

National medical research center identified a number of diseases, which can depend on the skin disease:

• Associated autoimmune conditions: Crohn's disease, celiac disease, sarcoidosis, and others;
• Eye diseases: cataract and glaucoma, and infectious processes;
• High blood pressure;
• Parkinson's Disease;
• Diabetes mellitus;
• Diseases of the liver and kidneys;
• Osteoporosis;
• Depression.

Note.With timely treatment and adherence to necessary guidelines and possible relapse of psoriasis can be reduced, and skin manifestations to minimize.

Recommended preventive measures:

1. Take daily bath with natural oils, salts and mild soap, containing no artificial flavorings and colorings;
2. Use moisturizer for the skin (in severe cases — twice a day), especially after receiving water treatments. It is not allowed to use hard towels. Simply apply to the skin a soft, dry cloth, and then use the cream;
3. Get enough sunlight. You should consult with your doctor to choose the "Golden mean". Too weak insolation will not bring noticeable effect, and too intense to increase the risk of skin cancer;
4. Avoid triggers such as Smoking, alcohol consumption, stress and infection;
5. Use aloe juice. You need to execute your lotion on the damaged skin several times a day. There are official studies that prove the effectiveness of this plant in combating inflammation of the skin;
6. Get at least three grams of omega-3 fatty acids per day. In the diet include fish, walnuts, flax seed oil or take capsules of fish oil. Fatty acids help to reduce inflammation in the body;
7. Helps to receive some special additions on the basis of barberry, tea tree oil or Dead sea salt.