Psoriasis
ICD-10 L40 · ICD-11 EA90

Treatment of Psoriasis in Adults with Palmoplantar Involvement

This protocol addresses psoriasis localised to the palms and soles — a distinct presentation that requires a targeted therapeutic strategy — in adults aged 18 years or older.

Clinical Scenario

Adults (age 18 or older) with active palmoplantar psoriasis, where lesions are confined to the hands and feet and the anatomical site shapes the selection of therapy.

Treatment Approach

The evidence-based approach for this presentation centres on targeted phototherapy — a category of light-based treatment particularly suited to localised palmoplantar disease.

Full protocol details, including therapy selection and sequencing, are available via the structured regimen.

Clinical Goal

Complete clearance of palmoplantar lesions

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jaad.2019.04.042

Topical PUVA is best suited for the treatment of localized psoriasis and is recommended in particular for palmoplantar disease.

Topical PUVA phototherapy is superior to localized NB-UVB light (311 to 313 nm) in the treatment of localized plaque psoriasis, particularly for palmoplantar psoriasis and palmoplantar pustular psoriasis, in adults.

Targeted UVB phototherapy, including excimer laser (308 nm) and excimer light (308 nm), is recommended for use in adults with plaque psoriasis, including palmoplantar psoriasis.

Specifically for palmoplantar plaque psoriasis and palmoplantar pustulosis, an excimer laser and excimer light were effective in multiple studies, with up to 57% of patients achieving complete clearance with a laser and more than 40% achieving substantial improvement with light.

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