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Palmoplantar pustulosis: Treatment

Giovanna Brunasso, MD
Cesare Massone, MD
Section Editor
Kristina Callis Duffin, MD
Deputy Editor
Abena O Ofori, MD


Palmoplantar pustulosis (PPP) is an uncommon chronic skin disorder characterized by recurrent eruptions of pustules on the palms and soles (picture 1A-F). Scale, erythema, pruritus, burning sensations, and pain are common associated features.

Although PPP involves a limited area, the disorder can have a significant negative effect on quality of life and can interfere with performance of activities of daily living. Patients with PPP on the soles of the feet may experience difficulty walking, and hand involvement may interfere with other activities.

PPP tends to have a prolonged course consisting of periods of exacerbation and partial remission. The treatment of the disease is often challenging, as responses to individual treatments are variable and unpredictable.

The management of PPP will be reviewed here. The clinical manifestations and diagnosis of PPP are reviewed separately. (See "Palmoplantar pustulosis: Epidemiology, clinical features, and diagnosis".)


High-quality data on the treatment of palmoplantar pustulosis (PPP) are limited, contributing to uncertainty about the ideal approach to treatment. Although multiple randomized trials have been performed, most are small and of poor methodological quality [1]. Moreover, the lack of a standardized method for assessing the response to treatment, as well as the wide variability in treatment regimens, complicate comparisons of study findings.

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Literature review current through: Jun 2020. | This topic last updated: Dec 04, 2019.
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