Health and FitnessWhat to know about Pustulosis Palmaris et Plantaris

AdminNovember 24, 202178 min

Pustulosis Palmaris et Plantaris, also known as Palmoplantar pustulosis (PPP), is a rare inflammatory skin disorder. It is a chronic and relapsing pustular condition, the pathogenesis of which is poorly understood.

This condition mainly affects hands and feet, forming tiny fluid-filled blisters with yellow-turbid pus, which turn brown and later into scales.

Palmoplantar pustulosis is more prevalent in women.

PPP is more common in women than men, especially in the middle age group. It predominantly triggers smokers, although unfortunately, quitting smoking does not often lead to an improvement.

Other triggering factors of PPP include:

  • infections (tonsillitis and chronic sinusitis),
  • psychological stress,
  • allergies, and
  • some drugs (beta-blockers and antidiabetic therapies).

How rare is Palmoplantar pustulosis?

PPP is a rare skin disease with relatively few statistics. In a more recent study from 2019, the database showed a 0.009% prevalence of PPP in the United States.

Is palmoplantar pustulosis a type of psoriasis?

While some dermatologists have proposed that PPP is a variant of psoriasis, others disagree with it. But, the truth is still debatable. The distinct nature of PPP, as opposed to psoriasis, is indicated by the late onset of the disease and the absence of typical psoriatic lesions.

There is, however, Pustular psoriasis, an uncommon form of psoriasis characterized by  clearly defined and raised bumps.

Several theories behind the cause of PPP

The cause of PPP is still controversial, and researchers have proposed a range of theories.

It can either be passed through genetics or have an autoimmune origin. Interestingly, it may also be a disorder of the eccrine sweat glands, which are numerous on palms and soles.

As prominent PPP patients are smokers, some studies showed that activated nicotine receptors in the sweat glands cause an inflammatory process.

PPP is not contagious

The scaling in the hands and soles of the feet may be sharp and prominent. However, the  pustules are sterile, free from germs, thus cannot spread from person to person.

Clinal features of Palmoplantar pustulosis

PPP varies in severity and may persist for many years. The probable symptoms of PPP are blisters and pustules which, often begin in a small area and spread to occupy a larger  space of the skin. The general symptoms of PPP are:

  • Pustules on hands and feet
  • Red, tender, and scaly skin
  • Painful cracks or fissures in the skin
  • Itchiness
  • Burning sensation in the lesions

Due to these symptoms, patients may have pain working with their hands and feet, interfering with their daily tasks and leisure activities. It also results in impairment of daily functioning and fulfilling social roles.

Managing Palmoplantar pustulosis

Since PPP comes and goes, there is no definitive cure for PPP. The general treatment  method involves the use of topical and systemic therapies, moisturizers, retinoid  medications in addition to phototherapy. However, the treatment of palmoplantar pustulosis is not always successful.

Furthermore, PPP can also be resistant to treatment with the use of potent remedies like immunosuppressive therapy.

Determining the cause of the disease is extremely valuable for the effective treatment of  PPP. Since the cause of PPP is still controversial, it may take time to find the best treatment of PPP that works for your specific case.


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