What is psoriasis on the tops of feet? How does it affect the feet and nails? What are the triggers and treatment options for this condition? Find comprehensive answers in this informative article.

Anatomy and Importance of the Feet

The feet are an essential part of the human anatomy, comprising 26 bones, 33 joints, and a complex network of muscles, tendons, and ligaments. The skin on the soles of the feet is unique, with a high concentration of sweat pores, and the thickest layers of skin on the human body to cope with the constant weight bearing. The feet are highly sensitive and act as sensors when walking or standing, making any interference or condition affecting the feet profoundly impact overall function and well-being.

Types of Psoriasis Affecting the Feet

Psoriasis on the feet, known as palmoplantar psoriasis, typically presents as thick, scaly plaques that can be painful and prone to cracking and bleeding. There are also other specific types of psoriasis that can affect the feet:

• Localised Pustular Psoriasis (Palmoplantar Pustular Psoriasis)

  This type affects about 5% of people with psoriasis, commonly occurring between the ages of 20 and 60, and is more common in women. It is characterized by the appearance of sterile, yellow/white pustules on the palms and soles, which can be painful and often have a cyclical pattern of recurrence.

• Acrodermatitis Continua of Hallopeau

  This is a rare form of localized pustular psoriasis that affects the tips of the fingers and, less commonly, the toes. It is usually triggered by some form of skin trauma and can be painful, frequently affecting the nails and potentially leading to nail loss. It is difficult to treat and may require systemic medications.

Nail Involvement in Psoriasis

Psoriasis can also affect the nails, with involvement of the nail plate causing pitting, ridging, thickening, lifting, and discoloration. This is due to abnormalities in the growth of tissue in the nail bed. Treatments for nail psoriasis typically target the nail bed or the nail folds, but can be challenging as the nail, once grown, can only be altered by filing or clipping.

Triggers of Psoriasis

The exact cause of psoriasis is not fully understood, but it is an inherited inflammatory disease that can be triggered by various events, illnesses, or injuries to the skin. A phenomenon known as Koebner’s phenomenon or Koebnerization can occur, where a psoriatic lesion develops in an area of traumatized skin that had not previously been affected by the condition.

Diagnosis and Seeking Medical Attention

If you suspect you may have psoriasis on your feet, it is recommended to seek a proper diagnosis. Visiting your general practitioner or a pharmacist is a good starting point, and you may also consider consulting a chiropodist (podiatrist), especially if your nails have become thickened and difficult to manage. A simple examination is often sufficient to diagnose psoriasis on the feet, but in some cases, further investigation may be necessary.

Treatment Options

The treatment of psoriasis on the feet, including the different types that can affect this area, typically involves a combination of topical, systemic, and sometimes biologic therapies. The specific treatment approach will depend on the severity of the condition, the presence of nail involvement, and the individual’s response to different treatments. It is important to work closely with healthcare professionals to develop a personalized treatment plan that can effectively manage the symptoms and improve the overall quality of life for those living with psoriasis on the feet.

Conclusion

Psoriasis on the feet, including the specific types of palmoplantar psoriasis and acrodermatitis continua of Hallopeau, can have a significant impact on an individual’s daily activities and overall well-being. Understanding the unique anatomy and sensitivity of the feet, as well as the various manifestations of psoriasis in this area, is crucial for proper diagnosis and effective management of this chronic condition. By seeking timely medical attention and working closely with healthcare professionals, individuals with psoriasis on the feet can explore appropriate treatment options and find relief from the associated symptoms.