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What Is Pustulosis?

Jillian O Keeffe
Jillian O Keeffe

Pustulosis is a form of psoriasis. Affected skin is inflamed and becomes bumpy. The name comes from the fact that the technical name for the bumps are called pustules. It usually affects the palms and the soles of the feet, which also develop flaky skin. The condition is controllable but not curable.

Palmoplantar pustulosis is another name for the condition. The disease usually shows up for the first time in adulthood. It occurs most often in people who smoke or who used to smoke. Genetics may play a role as the pustulosis can run in families. Stress may also increase the risk of the disease developing.


Only the hairless areas of the feet and the palms of the hand are usually affected. Tiny blisters grow out of the skin. At first, these blisters contain pus and are yellow. Then, the pustules dry out, turn brown, and start flaking. The skin around the pustules can also turn dry, red, and cracked.

Nobody knows exactly what causes pustulosis, and there is no cure. There are effective treatments, however, to keep the condition under control. Pustulosis tends to flare up over the course of years, but the triggers for recurrences are also unknown. A typical treatment regimen uses ointments or skin softeners to ease patient discomfort. Coal tar soaks or ointments can be beneficial.

Steroids are sometimes applied in an ointment form. The skin of the palms and feet is thick, so strong steroids are used. Adverse effects on skin and the potential for the steroid to become ineffective mean that the steroids are short-term treatments. A patient may benefit from wrapping his or her hands in dressings to encourage the ointment to sink in.

Nonsteroid medications may also help. One of the most effective is a drug called Soriatane®, but this also happens to have many side effects. The drug cyclosporin gives the best results, but it also has many side effects and is not recommended for use over the long term. Methotrexate, colchicine, tetracycline, and dapsone are other options.

Ultraviolet light treatments can clear up pustulosis in cases where medication hasn't worked. A few sessions a week may be required. Sometimes, the light therapy can be combined with taking the drug Oxsoralens®.

Sore and flaking hands and feet can make moving around and using the hands uncomfortable. Rubbing of footwear on the soles of the feet can exacerbate the condition. Avoiding use of the hands and feet and wearing shoes made from natural materials can help prevent the pustulosis from getting worse.

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