Table of ContentsView AllTable of ContentsSymptoms of Palmoplantar PustulosisCausesDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms of Palmoplantar Pustulosis
Causes
Diagnosis
Treatment
Frequently Asked Questions
Palmoplantar pustulosis (PPP) is a rare skin condition that’s hard to treat. It involves eruptions of sores called pustules on the palms of your hands or the soles of your feet.
Pustules areblistersfilled with a cloudy liquid. They can be itchy, painful, and cause a burning sensation. Some cases are severe enough to be debilitating.
This article walks you through the symptoms and causes of PPP, plus how it’s diagnosed and treated.
Verywell / Theresa Chiechi
The severity of PPP varies greatly from person to person. It can go on for years, and so far researchers don’t know what makes it flare. Symptoms of PPP can include:
Pressure, rubbing, or friction can make the symptoms worse.
After the pustules form, they may combine and form an area of red, thickened skin called an erythematous background, with scaly spots calledplaques. The skin may also develop painful cracks.
Types of Skin Lesions
Experts don’t yet know the exact causes of PPP, but it may be a disorder of the sweat glands. You have several of those on your palms and soles.
PPP is more common in people withpsoriasis. It may involveautoimmune or autoinflammatoryprocesses, where your immune system mistakenly attacks healthy cells.
Research shows that the condition is associated with:
Women are more likely to have PPP. It can start at any age, but most likely between 40 and 69.
A healthcare provider may be able to diagnose PPP on sight. They may take swabs to confirm that the blisters don’t contain pathogens (e.g.,bacteria,fungi).
If the diagnosis isn’t clear, they may perform a biopsy, but this is uncommon. During this procedure, a small skin sample is removed and sent to a lab for analysis.
Treatment options for PPP may include:
Some of these therapies may be used together. In severe cases,immunosuppressive drugsmay help. The first-line medications for PPP are:
If those don’t work or aren’t tolerated, the next ones to try may be:
It’s also advisable toquit smokingand avoid contact irritants (allergens, harsh soaps).
While smoking does contribute to PPP, quitting doesn’t always clear it up.
Summary
Palmoplantar pustulosis is a rare skin condition that causes blisters to erupt on the palms and soles. This may lead to red, scaly areas with skin that cracks easily. Pustules may itch, burn, or be debilitatingly painful.
The causes of PPP aren’t known. Smoking, bacterial infections, skin allergies, and genetics may play a role. Diagnosis may involve an exam, swabs of pustule fluid, or in rare cases, a biopsy.
Treatment for PPP may consist of topical steroids, retinoids, moisturizers, phototherapy, and immunosuppressants.
A Word From Verywell
A skin condition that’s both painful and unsightly can take a toll on you mentally and physically. Don’t hesitate to reach out to your healthcare provider about PPP and about any negative thoughts or feelings you have toward it. You may benefit from talking to a mental health professional.
Is palmoplantar pustulosis a type of psoriasis?
Does palmoplantar pustulosis go away?
Outbreaks of PPP will go away eventually, especially with treatment. PPP can’t be cured, though, so there’s never a guarantee that you won’t have another flare-up.
How rare is palmoplantar pustulosis?
PPP is quite rare. Between 0.01% and 0.05% of the population is estimated to have it.
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Osteopathic College of Dermatology.Palmoplantar pustulosis.DermNet NZ.Palmoplantar pustulosis.Freitas E, Rodrigues MA, Torres T.Diagnosis, screening and treatment of patients with palmoplantar pustulosis (PPP): a review of current practices and recommendations.Clin Cosmet Investig Dermatol. 2020;13:561-578. doi:10.2147/CCID.S240607Additional ReadingNational Organization for Rare Disorders.Palmoplantar pustulosis.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Osteopathic College of Dermatology.Palmoplantar pustulosis.DermNet NZ.Palmoplantar pustulosis.Freitas E, Rodrigues MA, Torres T.Diagnosis, screening and treatment of patients with palmoplantar pustulosis (PPP): a review of current practices and recommendations.Clin Cosmet Investig Dermatol. 2020;13:561-578. doi:10.2147/CCID.S240607Additional ReadingNational Organization for Rare Disorders.Palmoplantar pustulosis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Osteopathic College of Dermatology.Palmoplantar pustulosis.DermNet NZ.Palmoplantar pustulosis.Freitas E, Rodrigues MA, Torres T.Diagnosis, screening and treatment of patients with palmoplantar pustulosis (PPP): a review of current practices and recommendations.Clin Cosmet Investig Dermatol. 2020;13:561-578. doi:10.2147/CCID.S240607
American Osteopathic College of Dermatology.Palmoplantar pustulosis.
DermNet NZ.Palmoplantar pustulosis.
Freitas E, Rodrigues MA, Torres T.Diagnosis, screening and treatment of patients with palmoplantar pustulosis (PPP): a review of current practices and recommendations.Clin Cosmet Investig Dermatol. 2020;13:561-578. doi:10.2147/CCID.S240607
National Organization for Rare Disorders.Palmoplantar pustulosis.
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