This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Treatment of palmoplantar psoriasis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Palmoplantar psoriasis is difficult to treat.

Treatment principles:

Both hyperkeratosis and inflammation should be treated separately (1)

  • a keratolytic agent for hyperkeratosis (1)

  • calcipotriol or a moderately potent topical corticosteroid (e.g. betnovate-RD (R) ointment) may help. Topical coal tar and dithranol may also be of some benefit and some success can be achieved with photochemotherapy (8 methoxypsoralen-UVA phototherapy; PUVA) (2)

  • isotretinoin has also been used to treat pustular psoriasis

  • acitretin or methotrexate may be needed in disabling palmoplantar psoriasis (1)

  • secukinumab, a human monoclonal antibody, has evidence of benefit in moderate to severe palmoplantar psoriasis (4)

A suggested management protocol for primary care for adults (5):

  • in primary care (5):
    • stop smoking
    • dermovate ointment at night under polythene occlusion (e.g. Patches of Clingfilm (R))
    • a moisturiser of choice to be used through the day
    • early referral important for hand and foot PUVA/ Acitretin

The respective Summary of Product Characteristics must be checked before prescribing of any of the drugs mentioned above.


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page