Approach to Palmoplantar Pustulosis

Palmoplantar pustulosis is disease that manifests with grouped sterile pustules on the palms and soles. The disease manifests itself with recurrent grouped sterile pustules on a erythematous and keratotic basis, located on the palms and soles. The lesions may extend to the dorsum or the lateral aspects of the feet and hands. Various diseases can be considered in the differential diagnosis of the disease including pomphylox, dermatophyte infectios, scabies, insect bite, gonococcal infection, syphilis, palmoplantar psoriasis and acrodermatitis continua hallopeau. Treatment of the disease starts with general measures which are smoking cessation, use of emoillients and avoiding irritants. First line treatment modalities are topical corticosteroids, oral retinoids and phototherapy.