Palmoplantar Psoriasis
Localised to the palms and soles with thick scale, cracking and painful fissures; it hampers manual work and walking and markedly affects everyday life.
Clinic and treatment images
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Do you recognise these signs?
If one or more of these applies to you, we recommend a dermatological assessment.
- Sharply bordered, thickened red plaques on the palms and on the soles
- Dry, hard scale with painful, deep fissures that are prone to bleeding
- Sterile yellow-brown pustules in some cases, marking the pustular variant
- Marked pain and loss of function affecting grip, walking and manual work
Causes and triggers
- The psoriatic immune process settling on the skin of the palms and soles
- Smoking acting as a strong trigger, especially in the pustular palmoplantar type
- Friction, pressure and mechanical strain aggravating plaques via the Köbner effect
- Contact with irritants and occupational strain that worsen the signs
How we treat it
Support to stop smoking and identifying and reducing irritant exposures
Softening thick scale and repairing the fissures with ceramide barrier care
Targeted local phototherapy to the area, planned at 2–3 sessions weekly
Moving to systemic or biologic therapy for resistant, function-limiting disease
Why Clinovia?
Psoriasis and eczema are not only a surface problem. We assess the skin barrier, inflammation, nutrition and lifestyle, comorbidities and dermatological treatment together. Evidence-based dermatology remains the backbone; nutrition and lifestyle support that plan.
The Gut–Skin Relationship
We review digestive symptoms, dietary pattern and food-sensitivity history. The link between gut microbiome and inflammatory skin disease is still being researched, so it is addressed alongside — never instead of — dermatological treatment.
Cortisone-Free Protocol
First-line calcineurin and PDE-4 inhibitors, ceramide-based barrier repair and phototherapy instead of steroids; systemic and biologic steps when needed.
Systemic Repair
Vitamin D, zinc, omega-3 and iron levels plus thyroid and insulin resistance are screened, and any deficits found are built into the plan.
Measurable Follow-up
PASI/EASI and DLQI scores are tracked alongside laboratory values; steps that do not deliver a response are removed from the plan.
Palmoplantar psoriasis is a type in which the immune process settles on the palms and soles. Because these sites face constant pressure, friction and irritation, the plaques thicken here and turn into painful fissures. Smoking is an important trigger, particularly in the pustular type.
The skin of the palms and soles is thick and can resist treatment. Targeted local NB-UVB phototherapy concentrates the light directly on the affected area, improving the chance of a response. It is planned alongside cortisone-free topical care and barrier repair, with progress reviewed regularly.
Yes. For infant eczema and paediatric psoriasis we use age-appropriate topical stepping, a moisturising routine and, when indicated, paediatric phototherapy dosing.
Our standard protocols are cortisone-free. We work with topical calcineurin inhibitors, PDE-4 inhibitors, ceramide-based barrier repair, NB-UVB phototherapy and biologic agents when needed. Cortisone is considered only for very short, unavoidable situations and with the patient's consent.
Other conditions
Plaque PsoriasisThe most common form of psoriasis; it presents with well-defined, thickened plaques topped by silvery scale on the elbows, knees and trunk, often with itch.
Learn more
Guttate PsoriasisAn abrupt-onset form that often follows a throat infection, marked by numerous small, teardrop-shaped, lightly scaled plaques scattered across the trunk and arms.
Learn more
Scalp PsoriasisA stubborn form affecting the scalp, hairline and area behind the ears with thick, adherent scale; it often itches and can cause temporary hair shedding.
Learn more
NB-UVB PhototherapyNarrowband UVB at 311 nm calms inflammation in psoriasis and eczema without cortisone. Sessions run two to three times a week, with a typical course of 20–30 and PASI/EASI tracking.
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Biologic TreatmentsBiologic drugs selectively block targets such as IL-17 and IL-23 in psoriasis and IL-4/13 in eczema. They are considered in moderate-to-severe, resistant disease after screening.
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Systemic TherapySystemic drugs such as methotrexate, cyclosporine and acitretin are used in widespread or resistant psoriasis and eczema, alongside laboratory and safety monitoring.
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Let's build the right plan for your skin today
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- Written treatment plan
- Defterdar, Fethi Çelebi Cd. No:15, 34050 Eyüpsultan/İstanbul, Türkiye
- Mon–Sat: 09:00 – 19:00