Palmoplantar psoriasis: A phenotypical and clinical review with introduction of a new quality-of-life assessment tool - 08/08/11

Doi : 10.1016/j.jaad.2008.11.910

Elizabeth Farley, MD, Shamin Masrour, BS, Joanna McKey, MD, Alan Menter, MD ^⁎
Baylor University Medical Center, Dallas, Texas

Reprint requests: Alan Menter, MD, Baylor Research Institute, 3900 Junius St, Suite 145, Dallas, TX 75246.

Abstract

Background

Palmoplantar psoriasis is associated with significant quality-of-life issues. Its epidemiology and phenotypical expression remain ill defined.

Objective

We reviewed the literature and our clinical experience and developed a new quality-of-life assessment tool.

Methods

We conducted a retrospective review of 150 patients with palmoplantar psoriasis.

Results

In all, 78 (52%) patients displayed predominantly hyperkeratotic palmoplantar lesions, 24 (16%) pustular, 18 (12%) combination, and 30 (20%) had an indeterminate phenotype. In 27 (18%) patients, lesions were confined to the palms and soles. A new quality-of-life index was constructed to characterize disease severity. In all, 27 (18%) had mild, 72 (48%) moderate, and 51 (34%) severe disease involvement. Palmoplantar disease severity appeared independent from the degree of body surface area involvement.

Limitations

This was a retrospective review. The quality-of-life index remains to be statistically verified in prospective clinical studies.

Conclusion

Defining morphologic subtypes together with the use of a specific quality-of-life assessment tool in patients with palmoplantar psoriasis will improve our understanding and treatment of this recalcitrant form of psoriasis.

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Key words : hand and foot questionnaire, new assessment tool, palmoplantar psoriasis, phenotype, quality-of-life assessment tool

Abbreviations used : BSA, IRB, PPP