ABSTRACT
Palmoplantar psoriasis is a clinical subtype of plaque psoriasis characterized by its predomination on the palms and soles. The prevalence of palmoplantar psoriasis is reported in variable ranges, with the most recent literature revealing that 17.4% of psoriasis patients have palm and sole involvement. The clinical variants of palmoplantar disease include, most commonly, hyperkeratotic type, followed by pustular, combined, and indeterminate. One study found that 33% of palmoplantar psoriasis patients have a positive family history of psoriasis, 30% have a positive history of psoriatic arthritis, and 31% have a positive history of smoking. A personal history of psoriasis is helpful diagnostically because 86.3% of palmoplantar patients have minimal or mild psoriasis elsewhere on the body. On physical examination, palmoplantar psoriasis typically presents with erythematous, scaly plaques similar to those seen with plaque psoriasis. Nail involvement, particularly in the form of pitting, is also a guiding clinical clue in that 65% of palmoplantar psoriasis patients have nail findings.
