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 the soles of the feet, along with the process of localization on the scalp is one of the most common forms of the disease. This represents approximately 14% of the 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 increased frequency of developing the disease. There is a link with ethnicity. It has been 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 understood and it is still considered that the disease is a process autoimmune. In normal operation, the immunity a person receives protection against a variety of foreign agents, viruses, allergens, protozoa, and other microorganisms.

When the psoriasis is a failure in the body, then the immune system begins to produce substances aggressive 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 the inflammatory response and the excessive proliferation of the skin cells, causing the observed typical symptoms and the appearance of hyperkeratosis.

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

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

Additional risk factors are:

• The emotional stress and lability (sensitivity).
• Smoking and taking drugs.
• History of 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 relation of dermatological diseases, cardiovascular diseases and other conditions: hypertension, diabetes and hyperlipidemia.

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

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

• Sunburn;
• Stings-insect;
• 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 for a visual inspection of the skin by a physician without special equipment. A physical examination is based on the "psoriatic triad", the demonstrations 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;
• Take the penicillin, hydroxychloroquine.

In difficult cases, a comprehensive examination, which includes laboratory blood tests and ultrasound scanning, as well as the exclusion of the fungal infection using mycological diagnosis. If the testimony is doubtful biopsy of the lesion of the skin.

The symptoms and the first signs of Palmar-plantar psoriasis

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

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

To be an influence in the formation of nails:

• The nail plates may appear defects, holes;
• The nail is thick and discolored;
• Change your shape.

Palmar-plantar disease occurs as part of the global process, but is limited only to the skin of the palms of the hands and feet. Psoriasis of the plant makes it difficult to walk and wearing shoes. Damage to the hands can not only prevent the execution of any work, but also the imposition of a negative impact in relationships with people. Ordinary situation, like a welcome hand, can be uncomfortable, 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 called with the following terms:

• Palmar-plantar pustular psoriasis Barber;
• Purulent psoriasis;
• Dermatitis pustular.

List disorder of the skin that causes the formation of conglomerates (clusters) of several pustules in the region of the plates. In general, these rashes are very similar to normal pimples. It should be noted that this type of disease is quite easy methods to treat and often requires an integrated approach to therapy.

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

Stage Palmar-plantar psoriasis

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

1. The initial phase. The appearance of lesions on the hands and feet. The plates have a characteristic hue of red, there may be purulent inclusions white; 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 disappears, and the color of the plate becomes less bright.
3. The final phase. Accompanied by the regression of elements, pruritus is absent. The treatment is supportive, whether it is excluded at all; that provides recommendations for the maintenance of remission and prevention of relapse.

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

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

Treatments

Palmar — plantar psoriasis is a chronic disease, which may appear repeatedly, regardless of the treatment. However, there are therapies to achieve reduction in terms of acute and prolong the period of remission.

The main treatment is to try to prevent the rapid growth of the elements in the cell that lead to the development of the plates is to be performed anti-inflammatory therapy. An alternative technique provides for the immediate removal of the stairs.

Because the skin on the palms and the soles of the feet are joined, even in healthy people, treatment of this localization often involves a combination of techniques 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:

• The vitamin D analogs;
• Ointments based on corticosteroids;
• Retinoids;
• Anthralin;
• Special resin;
• Salicylic acid;
• Moisturizer to reduce inflammation and relieve the 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. Later you can gradually increase the exposure time of 30 seconds per day.

Drugs for the treatment of Palmar-plantar psoriasis

Palmar-plantar psoriasis includes treatment with oral medications, to more severe form of the disease:

• Methotrexate;
• Retinoids;
• Cyclosporine;
• Biologic medicines that reduce the activity of the immune system;
• Thioguanine;
• Hydroxyurea.

The most frequent side effect called medicines are problems with the gastrointestinal tract.

The disease and the prevention

Severe course of the disease, to a certain extent, can affect the development of serious diseases that threaten the health and life of patients: 58% increase in the risk of myocardial infarction and 43% at a stroke. The main complications immediate of psoriasis of the palms and soles is psoriatic arthritis and nail dystrophy.

National medical research centre have identified a number of diseases, which may depend on disease of the skin:

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

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

Recommended preventive measures:

1. Take daily bath with natural oils, salts and mild soap, does not contain artificial fragrances and dyes;
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 sunlight does not lead to noticeable effect, and too intense will increase the risk of skin cancer;
4. Avoiding the triggers, such as Smoking, alcohol consumption, stress, and infection;
5. Use of aloe juice. You must complete the lotion on the damaged skin several times a day. There are official studies that prove the effectiveness of this plant in the fight against inflammation of the skin;
6. Get at least three grams of omega-3 fatty acids per day. In the diet include fish, walnuts, oil of a seed of flax or taking capsules of fish oil. The fatty acids help to reduce inflammation in the body;
7. Helps to receive some special additions on the basis of the barberry, tea tree oil or Dead sea salt.