Palmar psoriasis develops on the palms of the hands and pads of the fingers. The University of Maryland Medical Center reports that with palmar psoriasis, red patches of skin on the palms of the hands develop pus-filled blisters. These blisters eventually become brown, turn scaly, and peel off. Palmar psoriasis can cause a great deal of emotional stress, as it is a condition that cannot easily be hidden. However, there are a few good treatment options.
Topical Treatment
The first treatment tried with palmar psoriasis is usually a topical application. According to the New Zealand Dermatological Society (NZDS), there are a few different types of topical treatments that may be effective. Often the first application used is an emollient, which is a thick cream that is applied to the affected area often. Emollient provides a barrier between the skin and outside irritants, and it moisturizes the skin which reduces flaking, cracking and further drying. Coal tar is a topical treatment for palmar psoriasis that has been around for some time. It is a byproduct of the manufacturing of coal and petroleum, and works by reducing itching, scaling and the swelling on the hands. Since it is messy, it is often applied in the evening and covered with gloves for overnight. Salicylic acid is sometimes used alone, or in conjunction with coal tar or other treatments. It speeds up the sloughing off of dead skin cells, which reduces the scaling and cracking of the skin. Other treatments are topical steroid creams, which reduce the inflammation and itch of palmar psoriasis.
Oral Medication Treatment
Palmar psoriasis that is more severe may require the use of a systemic agent as treatment. A systemic agent is one that affects the entire body, rather than being isolated to one spot. According to the Mayo Clinic, oral medications for psoriasis include retinoids, methotrexate and cyclosporine. These medications work by reducing the body's production of skin cells, and controlling inflammation. One of the top oral medications that is particularly effective for palmar psoriasis, as noted by the NZDS, is Acitretin.
Phototherapy Treatment
Phototherapy involves exposing the skin to controlled doses of natural or artificial UVB or UVA rays. Exposure to these rays will slow down the production of skin cells, which results in a reduction of the scaling and inflammation of the skin. Often, light therapy is given in conjunction with topical treatments, such as coal tar, as the topical treatments make the skin more sensitive and receptive to the light. Another form of phototherapy treatment for palmar psoriasis is called PUVA (psoralen plus ultraviolet A). PUVA is sometimes referred to as photochemotherapy, as it involves ingesting a medication called psoralen before being exposed to UVA light. The psoralen makes the skin more sensitive to the UVA rays, which allows them to penetrate deeper. PUVA treatments are usually reserved for the most severe cases of palmar psoriasis.
