Psoriasis on the Hands and Feet (Palmoplantar Psoriasis)

What is psoriasis on the hands and feet?

Psoriasis is a chronic condition that affects the skin on your body, including on your hands and feet. It occurs as a result of an overactive immune system. Symptoms of psoriasis on your hands and feet look like a patch of itchy, scaly and discolored skin, which is called a plaque.

Psoriasis on the hands and feet is also called palmoplantar psoriasis. It can target your:

• Palms.
• Soles.
• Fingers and toes.
• Webbing between your fingers and toes.
• Skin on top of your hands and feet.
• Wrists and ankles.
• Fingernails or toenails.

What types of psoriasis affect my hands and feet?

“Psoriasis” is a broad term to identify skin inflammation that causes scaling. Symptoms of psoriasis are different for each type, and some types are more common to affect the skin on your hands and feet, including:

• Plaque psoriasis.
• Guttate psoriasis.
• Pustular psoriasis.
• Nail psoriasis.

Who does psoriasis on the hands and feet affect?

Psoriasis on the hands and feet affects people diagnosed with psoriasis. Psoriasis is a chronic condition, and symptoms can flare up anywhere on your body, including on your hands and feet.

How common is psoriasis on the hands and feet?

Psoriasis affects millions of people in the United States. Specifically, up to 5% of the U.S. population has psoriasis and 3% to 4% of all cases of psoriasis affect a person’s hands and feet at some point in their lifetime.

Is palmoplantar psoriasis the same as palmoplantar pustulosis?

Both palmoplantar psoriasis and palmoplantar pustulosis affect the skin on your hands and feet. The conditions are different based on the symptoms they cause. Psoriasis causes a scaly patch of discolored skin on your hands and/or feet. Pustulosis, which is a subtype of psoriasis, includes a scaly patch of discolored skin with the addition of pus-filled bumps or blisters on the patch of skin.

What’s the difference between psoriasis and eczema on the hands and feet?

Psoriasis on your hands and feet can look similar to another skin condition called eczema. Eczema causes a dry, discolored and itchy rash on your skin. Psoriasis causes scales and flakes on a patch of discolored skin. A healthcare provider will be able to identify the difference between both conditions by a visual examination of your symptoms. While both conditions are different, it’s possible to have both psoriasis and eczema at the same time.

What are the symptoms of psoriasis on the hands and feet?

Symptoms of psoriasis on the hands and feet include a patch of skin with:

• Scales or flakes.
• Skin discoloration.
• Itchy skin.
• Dry skin.

Certain types of psoriasis, like palmoplantar pustulosis, can cause fluid- or pus-filled blisters or pustules that can turn yellow to brown and then become scaly.

What causes psoriasis on the hands and feet?

An overactive immune system causes psoriasis. Your immune system fights off foreign invaders like bacteria to keep your body healthy. If you have psoriasis, your immune system mistakes healthy skin cells for foreign invaders. As a result, it makes your cells divide and replicate too quickly. This causes dead skin cells to move to the surface of your skin, causing symptoms of flaky, scaly skin.

The reason why psoriasis localizes to your hands and feet, or any other part of your body, is unknown.

Is psoriasis on the hands and feet contagious?

No, psoriasis isn’t contagious. You can’t spread the skin condition to other people by physical contact.

How is psoriasis on the hands and feet diagnosed?

A healthcare provider will diagnose psoriasis on your hands and feet after a physical exam. During the exam, they’ll go over your medical history, including asking questions about your allergies, skin irritants or if you have a biological family history of skin conditions like psoriasis.

Psoriasis can look similar to other skin conditions like eczema, so your provider might offer a test to rule out other conditions or to confirm a diagnosis. Common tests could include a skin biopsy or an allergy test.

You may need to visit a dermatologist to receive a psoriasis diagnosis.

How is psoriasis on the hands and feet treated?

Treatment for psoriasis on the hands and feet could include:

• Topical creams or ointments with ingredients like emollients, urea, salicylic acid or coal tar.
• Topical medications like corticosteroid or calcipotriene creams.
• Oral medications like retinoids, acitretin, methotrexate and cyclosporine.
• Light therapy or phototherapy.
• Biologics like etanercept or infliximab.

Some of these medications could cause side effects, especially if you’re taking medications that could interact with these drugs or if you’re pregnant, nursing or planning on becoming pregnant. Talk to your healthcare provider before starting treatment to see if there are side effects.

How soon after treatment will I feel better?

It could take several weeks to see results from your treatment for psoriasis on your hands and feet. Once you begin treatment, you might feel immediate relief from itchiness. Plaques on your skin or scaly patches can last for a couple of weeks to several months, even with treatment. Your healthcare provider will create a treatment plan to help your skin clear up so you can feel better sooner.

How can I prevent psoriasis on the hands and feet?

There’s no known way to prevent psoriasis, but you can reduce your risk of developing a flare-up of psoriasis symptoms on your hands and feet by:

• Washing the skin of your hands and feet often, with a gentle soap and water.
• Using moisturizers regularly on your skin.
• Identifying triggers that cause your psoriasis symptoms to flare up and avoid those triggers.
• Wearing sunscreen when you go outdoors.
• Eating a healthy diet and exercising regularly.
• Managing your stress.

What can I expect if I have psoriasis on the hands and feet?

Psoriasis is a chronic skin condition. This means it can come and go throughout your life and there isn’t a cure. Treatment is available to help you manage your symptoms when they do flare up.

Flare-ups can happen if you come into contact with irritants and allergens in your environment. These are called triggers. Triggers activate your immune system, which causes it to overreact. Common triggers could include stress or sun exposure. Work with your healthcare provider to identify triggers in your environment that cause your symptoms to flare up. Avoiding these triggers can reduce the amount of symptoms you experience.

When should I see my healthcare provider?

Visit your healthcare provider if you:

• Have symptoms that get worse after treatment begins.
• Experience severe pain, discomfort or itchiness.
• Have signs of an infection like fever, pain, swelling or a wound that oozes fluid.

What questions should I ask my doctor?

• What type of psoriasis do I have?
• Are there side effects to the medication?
• How often should I apply topical medications to my skin?
• When will my symptoms go away?

A note from Cleveland Clinic

Psoriasis can be an irritating condition because it’s chronic and flares up unexpectedly throughout your lifetime. Some people find comfort in talking with a mental health professional if the symptoms of psoriasis affect their self-confidence. Your healthcare provider will help you manage your condition so symptoms are minimal and don’t cause a disturbance to your lifestyle.