Palmoplantar psoriasis

A phenotypical and clinical review with introduction of a new quality-of-life assessment tool

Farley, Elizabeth MD
Masrour, Shamin BS
McKey, Joanna MD
Menter, Alan MD

Baylor University Medical Center, Dallas, Texas

Reprint requests: Alan Menter, MD, Baylor Research Institute, 3900 Junius St, Suite 145, Dallas, TX 75246. E-mail: [email protected].

Funding sources: None.

Conflicts of interest: None declared.

Journal of the American Academy of Dermatology 60(6):p 1024-1031, June 2009.

Background

Palmoplantar psoriasis is associated with significant quality-of-life issues. Its epidemiology and phenotypical expression remain ill defined.

Objective

We reviewed the literature and our clinical experience and developed a new quality-of-life assessment tool.

Methods

We conducted a retrospective review of 150 patients with palmoplantar psoriasis.

Results

In all, 78 (52%) patients displayed predominantly hyperkeratotic palmoplantar lesions, 24 (16%) pustular, 18 (12%) combination, and 30 (20%) had an indeterminate phenotype. In 27 (18%) patients, lesions were confined to the palms and soles. A new quality-of-life index was constructed to characterize disease severity. In all, 27 (18%) had mild, 72 (48%) moderate, and 51 (34%) severe disease involvement. Palmoplantar disease severity appeared independent from the degree of body surface area involvement.

Limitations

This was a retrospective review. The quality-of-life index remains to be statistically verified in prospective clinical studies.

Conclusion

Defining morphologic subtypes together with the use of a specific quality-of-life assessment tool in patients with palmoplantar psoriasis will improve our understanding and treatment of this recalcitrant form of psoriasis.