II. Pathophysiology
- Chronic inflammatory skin disease
III. Epidemiology
- Occurs most often in middle aged adults
IV. Risk Factors
- Tobacco Abuse
- Thyroid disease
- Emotional stress
- TNF Inhibitor
- Streptococcus infection
V. Symptoms
- Burning pain and Pruritus on the palms and soles
- Painful ambulation due to sole lesions
VI. Signs
VII. Labs
-
Potassium Hydroxide stain (KOH Preparation)
- Exclude Tinea Pedis or Tinea Manum
- Skin biopsy
- Confirms diagnosis (not required)
VIII. Differential Diagnosis
IX. Associated Conditions
X. Management
- Similar to Psoriasis management starting with high potency Topical Corticosteroids
- Typically managed by dermatology
-
General measures
- Skin Lubricants
- Avoid topical irritants and allergans
- Tobacco Cessation
- First-line agents
- High potency Topical Corticosteroids (may be ineffective)
- Oral Retinoids
- Calcipotriene (Donovex)
- Photochemotherapy (e.g. PUVA)
- Second-line agents
XI. References
- Fitzpatrick (1992) Color Atlas Dermatology, p. 52-3
- Pesqueira (2019) Am Fam Physician 100(9): 579-80 [PubMed]