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.
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.
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.
Complete clearance of palmoplantar lesions
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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