Due to the peculiarities of the clinical course hand-foot psoriasis significantly impairs the patient's quality of life. The disease is resistant to many therapies and can cause systemic complications. It is closely associated with autoimmune disorders. The disease often manifests itself at a young age immediately after puberty or in elderly (over 50 years) patients. Modern methods of treatment do not allow to completely get rid of the pathology, however, a number of medicines and procedures from the arsenal of physiotherapy stop the clinical manifestations of the disease. Read about the principles of diagnosis and treatment of palmoplantar psoriasis on estet-portal.com in this article.
- Etiology and mechanism of development of palmoplantar psoriasis
- Clinical features of palmoplantar psoriasis
- The subtleties of the treatment of palmoplantar psoriafor
Etiology and mechanism of development of palmoplantar psoriasis
Psolar palmar-plantar psoriasis – systemic disease characterized by complex pathogenesis. The appearance of external manifestations is based on a “failure”; in the proliferation and differentiation of epithelial cells of the epidermis. The exact cause of these disorders is unknown. But it is assumed that the pathology is a consequence of autoimmune disorders caused by chronic sensitization, metabolic disorders, and the effects of constant stress. There is no doubt about the role of genetic predisposition.
The following factors take part in the development of pathology:
- an increase in the concentration of T-lymphocytes in the lesions with their simultaneous decrease in the peripheral circulation;
- increase in blood fibrokinetin;
- change in the ratio of lymphocytes – helpers and suppressors;
- in the affected epidermis, the concentration of interleukin type 6, which stimulates cell mitosis, is increased.
Changes in hormonal levels during puberty (often palmoplantar psoriasis manifests itself with the onset of menstruation), pregnancy can provoke the onset of symptoms of palmoplantar psoriasis.
Pathology also occurs after a psycho-emotional shock, trauma, allergic contact dermatosis, streptococcal infection. Also, patients note the inhibition of the endocrine activity of the adrenal cortex, slowing down the metabolism.
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Clinical features of palmoplantar psoriasis
Palmar-plantar psoriasis occurs in people who are connected by the duty of their professional activities or lifestyle with heavy physical labor. Depending on the characteristics of the course, several types of the disease are distinguished.
Papular-plaque appears as single or grouped papules, covered with a silvery or yellow coating, resembling scales in appearance. Unlike other forms of dermatosis, with palmoplantar psoriasis, plaque is scraped off with difficulty. Pathological keratinization is accompanied by the appearance of painful skin lesions.
The horny type is characterized by large callus-like formations. Plaque and scales are absent or poorly expressed.
Barber's dermatosis is accompanied by the appearance of blisters filled with a thick infiltrate. Then the pustules dry up and turn into rashes characteristic of other forms of palmar-plantar psoriasis.
The disease proceeds with damage to the nail plates on the hands. This manifests itself in the form of increased fragility, deformation and loosening, pigmentation disorders, the appearance of areas of subungual hemorrhages.
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The subtleties of the treatment of palmoplantar psoriasis
To confirm the diagnosis of palmar-plantar psoriasis, physical examination data and the collected anamnesis are sufficient.
To differentiate between palmoplantar psoriasis and mycosis, microscopy and skin biopsy are performed.
General principles of treatment of palmoplantar psoriasis include the use of drugs with desensitizing and detoxifying effects, antihistamines, systemic retinoids. In the absence of results from other methods of conservative treatment, corticosteroids and cytostatics are prescribed. Softening ointments with a keratolytic effect are applied locally. Phototherapy indicated.
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