It may be possible to treat psoriasis affecting the hands and feet with localised phototherapy. The use of phototherapy (ultraviolet light) may be considered, but availability and access to appropriate centres can sometimes be limited. Treatmentsįor plaque psoriasis on the foot, treatment will generally be similar to those recommended for other areas of the body, with the use of topical (applied to the skin) creams, ointment and gels. It is unlikely that any specific test will be performed unless there is a suspicion of a fungal infection, when some samples may be taken for laboratory analysis. Psoriasis on a foot or both feet may be diagnosed by simple examination, but if there is any doubt then referral to a specialist (dermatologist) may be required. Alternatively, you may wish to see a local chiropodist (sometimes known as a podiatrist), particularly if your nails have become thickened and difficult to manage. Visiting your GP or asking your pharmacist is a good place to start. If you think you may have psoriasis on your foot or feet, it is best to get a diagnosis. Koebner found that people with psoriasis whose skin became traumatised following an injury, often developed a psoriatic lesion in the area, but where psoriasis had not previously been seen such sites include cuts, bruises, burns, bumps, vaccinations, tattoos and other skin conditions. A particular process known as Koebner’s phenomenonor Koebnerisation is named after the German dermatologist Heinrich Koebner. It can be triggered by events, illness or injury to the skin. It is not fully understood what causes psoriasis, but it is an inherited inflammatory disease. ![]() Treated inflammation in these tissues can result in better nail growth with fewer features of psoriasis, but treatment of nail psoriasis can be difficult. Treatments are usually directed at the nail bed or the nail folds that tuck around the edges. The nail is made of modified skin and, once it has grown, it can only be altered by filing or clipping. In people who develop psoriasis of the nails, it is involvement of the nail plate that causes pitting, ridging, thickening, lifting and discolouration of the nail due to abnormalities in the growth of tissue in the nail bed. Nails grow from the nail plate, which is just under the cuticle. ![]() Nail psoriasis is very common, yet no one knows why some people get nail involvement and others do not. Given they are part of the skin, it is perhaps not surprising that nails can be affected by a skin disease such as psoriasis. Topical treatments are usually not very successful but occasionally systemic medications may help to clear the lesions and restore the nails. It is difficult to treat and many therapies have been tried. Bone changes can be seen in severe cases. It tends to be painful and frequently affects the nails. It usually starts after some trauma to the skin. ![]() This looks similar to palmoplantar pustular psoriasis, but is localised to the ends of the fingers and, less commonly still, the toes (acropustulosis). ![]() See Pustular psoriasis.Īcrodermatitis continua of Hallopeau is a very rare form of localised pustular psoriasis. The natural history of the disease is usually cyclical (occurring often or repeatedly), with the appearance of new crops of pustules followed by periods of low activity in which the pustules resolve. After time, the pustules dry up and resolve, leaving brown stains on the skin surface. These pustules are sterile, which means they are not the result of infection. PPP is normally recognisable by yellow/ white pustules approximately 2-3mm in diameter, appearing on fleshy areas of hands and feet, such as the base of the thumb and the sides of the heels. As in all types of psoriasis, infection and stress are suspected trigger factors. PPP causes pustules on the palms and soles. About 10-25% of people with PPP have a family history of psoriasis but the precise reason why some people develop it is not known. It can be painful and is more common in women than men. It occurs most commonly between the ages of 20 and 60. Localised pustular psoriasis also known as palmoplantar pustular psoriasis (PPP) – affects about 5% of people with psoriasis. Localised pustular psoriasis – also known as palmoplantar pustular psoriasis (PPP) – affects about
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