Can Psoriasis Affect Hands and Feet?

People with psoriasis have a chronic inflammatory autoimmune condition that causes patches of skin, called “plaques,” to form on the skin. Plaques are patches of inflamed and thickened skin that can be covered in silvery scales.

Sometimes psoriasis plaques can occur on the soles of the feet and/or the palms of the hands. The medical name for this is “palmoplantar psoriasis.”

What are the symptoms of palmoplantar psoriasis?

When psoriasis plaques form on the palms of the hands or the soles of the feet, they can cause the skin to become very red, dry, and thickened. This can cause blisters and swelling, and can often lead to deep cracks called “fissures” to form in the plaques.

These fissures can be very deep and quite painful. The symptoms of palmoplantar psoriasis usually occur on the soles of both feet or the palms of both hands (not just the right side or the left side). These symptoms tend to be longer lasting than psoriasis that affects other parts of the body.¹

Palmoplantar psoriasis can cause very painful symptoms due to the location of the plaques. It can make standing and walking difficult as well as anything that involves using the hands. Palmoplantar psoriasis symptoms can have a large effect on a person’s quality of life and ability to carry out usual day-to-day activities.

A flare-up of palmoplantar psoriasis happens when symptoms suddenly get worse on the soles and/or palms. This might happen due to a trigger, such as a skin injury or infection². It can also be caused by experiencing a period of emotional stress, or by taking certain medications.

How is palmoplantar psoriasis treated?

It is important to treat the symptoms of a palmoplantar psoriasis flare-up as quickly as possible. For milder symptoms, healthcare providers may recommend topical treatment options. Topical treatments are medicines that are applied directly to the parts of the skin that are affected by symptoms.

An over-the-counter topical treatment that can be particularly helpful for palmoplantar psoriasis symptoms are called emollients. Emollients are very thick creams that can be used regularly on the palms and soles to moisturize the skin and prevent painful fissures.

Many people find that a combination of topical treatments is more effective in controlling symptoms of palmoplantar psoriasis than individual treatments are¹. For example, the combination of:

• Coal tar
• Salicylic acid
• Topical corticosteroids
• Calcipotriene (Vitamin D synthetic)

Coal tar is a treatment that can help to lessen the amount of excess skin growth that causes the plaques to form. Salicylic acid is a treatment that helps to lift scales off of the plaques and reduce thickening of the skin.

Topical corticosteroids are prescription creams or ointments that work by reducing the inflammation that contributes to the formation of plaques. It is very important to use corticosteroids exactly as directed because they can cause serious side effects if taken too long or at too high of a dose.

For people who have more severe palmoplantar psoriasis symptoms, topical treatments may not be effective enough. Healthcare providers may recommend that these patients try treatment with ultraviolet light therapy or systemic medicines.

Systemic medicines are different than topical medicines because they have an effect on the entire body system’s function². Methotrexate is a systemic medicine that seems to work well for many people with palmoplantar psoriasis. Other systemic medicines that are used to treat people with severe palmoplantar psoriasis are cyclosporine, Soriatane (acitretin), and various kinds of biologic therapies.

Tips for living with palmoplantar psoriasis

Applying topical creams to areas of the body affected by plaque psoriasis can be messy, and the creams may also have strong odors.

This can be a particular problem for people with palmoplantar psoriasis, who need to apply the medicine to their soles and palms¹. One strategy for dealing with this problem is to apply the medicines under cotton socks and/or cotton gloves.

Another tip that some people use is to apply super glue to close up deep fissures on the soles or palms². But be very careful in applying the glue - having someone else help is a good idea.