palmoplantar pustulosis; pustulosis palmaris et plantaris
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Etiology
- chronic plaque psoriasis (10-25%)
- gluten sensitive enteropathy
- diabetes mellitus type 1
- thyroid disease
- Streptococcal pharyngitis
- SAPHO syndrome (rare)
- TNF-alpha inhibitors
Pathology
- may be a disorder of the eccrine sweat glands (numerous on palms & soles)[1]
Genetics
- several members of a family may be affected[1]
Clinical manifestations
- presents as crops of sterile pustules on one or both hands &/or feet
- associated with thickened, scaly, red skin that easily develops painful fissures
- variable in severity
- may persist for years[1]
* images[1]
Laboratory
- skin biopsy rarely necessary