What are the palmoplantar dermatoses that affect the palms and soles?

Palmoplantar Dermatoses: Comprehensive List

The main palmoplantar dermatoses affecting palms and soles include psoriasis, eczema, and palmoplantar pustulosis, with psoriasis being the most common at 20.7% of cases. 1

Common Palmoplantar Dermatoses

Inflammatory Conditions

• Psoriasis variants:

  • Palmoplantar psoriasis (most common at 20.7% of palmoplantar dermatoses) 1
  • Pustular psoriasis
  • Hyperkeratotic palmoplantar psoriasis

• Eczematous conditions:

  • Dyshidrotic eczema
  • Hyperkeratotic hand dermatitis
  • Allergic contact dermatitis
  • Keratolysis exfoliativa (6%) 1

• Other inflammatory conditions:

  • Palmoplantar pustulosis
  • Hand-foot skin reaction (HFSR) - associated with VEGFR inhibitors 2
  • Palmar-plantar erythrodysesthesia syndrome (PPES) - associated with chemotherapy 2, 3
  • Periarticular thenar erythema with oncolysis (PATEO) syndrome - associated with docetaxel 2

Infectious Causes

• Fungal infections:

  • Moniliasis/Candidiasis (19% of palmoplantar dermatoses) 1
  • Dermatophytosis (tinea manuum/pedis)

• Bacterial infections:

  • Pitted keratolysis (6%) 1
  • Erythrasma

• Viral infections:

  • Warts (verruca vulgaris/plantaris)
  • Hand-foot-mouth disease

Keratodermas

• Acquired palmoplantar keratodermas:

  • Keratoderma climactericum
  • Drug-related keratoderma
  • Malnutrition-associated keratoderma
  • Chemically-induced keratoderma
  • Systemic disease-related keratoderma
  • Malignancy-associated keratoderma
  • Dermatoses-related keratoderma
  • Infectious keratoderma
  • Idiopathic keratoderma 4

• Hereditary palmoplantar keratodermas (not the focus of this answer but mentioned for completeness)

Other Conditions

• Palmoplantar hyperhidrosis (7%) 1
• Palmar erythema - associated with liver disease, pregnancy, rheumatoid arthritis, thyroid disorders 3
• Lichen planus
• Reactive arthritis (Reiter's syndrome)
• Acrokeratosis paraneoplastica (Bazex syndrome)
• Acrodermatitis continua of Hallopeau
• Erythema multiforme
• Palmoplantar lichen nitidus

Epidemiology and Distribution Patterns

• Female predominance with a ratio of 1.2:1 1
• Peak incidence in the 21-30 years age group 1
• Housewives are most commonly affected (30%) 1
• Distribution patterns:
  • Both palms and soles involvement: 44.3% of cases (most common pattern)
  • Only palms: 28% of cases
  • Only soles: 27.3% of cases 1

Disease-Specific Distribution Patterns

• Most common condition affecting only palms: Keratolysis exfoliativa (16.7%) 1
• Most common condition affecting only soles: Moniliasis (41%) 1
• Most common condition affecting both palms and soles: Palmoplantar psoriasis (41.4%) 1

Associated Findings

• Nail changes occur in 26.6% of palmoplantar dermatoses, most commonly in palmoplantar psoriasis (62.5%) 1
• Associated dermatological conditions are seen in 14.3% of patients 1

Understanding the specific distribution patterns and associated findings can help in narrowing down the differential diagnosis when evaluating patients with palmoplantar dermatoses.