What Does Psoriasis Look Like on Your Hand?

Reviewed on 7/22/2021

Psoriasis on the palms of the hands or soles of the feet is called palmoplantar psoriasis. Symptoms of psoriasis on the hands may include patches of skin on the hands (red or dark, thick and dry, or silvery-white scales). It may also cause the fingernails to appear pitted, thick, ridged, crumbly, or discolored.
Psoriasis on the palms of the hands or soles of the feet is called palmoplantar psoriasis. Symptoms of psoriasis on the hands may include patches of skin on the hands (red or dark, thick and dry, or silvery-white scales). It may also cause the fingernails to appear pitted, thick, ridged, crumbly, or discolored.

Psoriasis is a chronic autoimmune skin condition that causes skin to be red, thick, scaly, and flaky. When it occurs on the palms of the hands or soles of the feet, it’s called palmoplantar psoriasis, and it affects about 40% of people with psoriasis

In addition, fingernails and toenails may be affected. Psoriatic nail disease can cause symptoms in the nail bed and the area where fingernails and toenails start their growth. 

Palmoplantar pustular disease (pustulosis) occurs in about 5% of patients who have psoriasis and appears as small, pus-filled blisters on reddened, tender skin. It can also cause painful cracking and fissuring.

Symptoms of psoriasis on the hands may include:

  • Patches of skin on the hands 
    • Look red or dark
    • Are thick and dry
    • Silvery-white scales that itch or burn 
    • Small, pus-filled blisters on reddened, tender skin (palmoplantar pustular disease)
    • Painful cracking and fissuring (palmoplantar pustular disease)
  • Nail changes – nails may look
    • Pitted
    • Thick
    • Ridged
    • Crumbly
    • Discoloration
      • Yellow-brown or yellow-red color
      • Darkening 
    • White or reddish spots
    • Separation of the nail from the nail bed (onycholysis)
  • Painful swelling of fingers (may also occur in the toes) (dactylitis, often called “sausage digits” because fingers may look like sausages)

How Do You Treat Psoriasis on the Hands?

Treatments are aimed at relief of symptoms of psoriasis on the hands, though there is no cure. 

Treatments for other types of psoriasis such as TNF-alpha inhibitors including infliximab and adalimumab may trigger palmoplantar pustulosis and are generally not prescribed.

Topical treatments mild psoriasis on the hands may include:

  • Emollients
    • Thick, greasy barrier creams to moisturize dry, scaly skin and help prevent painful cracking
  • Keratolytic agents 
    • Including urea or salicylic acid to help thin down thick scaling skin
  • Coal tar
    • Helps improve scale and inflammation    
  • Topical steroids
    • Potent ointment used to reduce inflammation, itch and scaling

Severe cases of palmoplantar psoriasis may be treated with: 

QUESTION

Psoriasis causes the top layer of skin cells to become inflamed and grow too quickly and flake off. See Answer

Health Solutions From Our Sponsors

Reviewed on 7/22/2021
References
https://www.uptodate.com/contents/psoriasis-the-basics?search=psoriasis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.psoriasis.org/

https://dermnetnz.org/topics/psoriasis-of-the-palms-and-soles/