Psoriasis on Feet: Types, Causes, Symptoms and Treatment

02 Apr 2024, by

Dr. Lusine Badalian

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Psoriasis, including the type that affects the feet, impacts an estimated 7.5 to 8 million people in the United States and around 125 million globally, according to WebMD. This autoimmune skin condition can cause discomfort, affecting daily life significantly. Psoriasis on the feet, or palmoplantar psoriasis, presents unique challenges, such as painful, cracked skin and mobility issues. Early diagnosis and a tailored treatment approach are crucial for managing symptoms and improving quality of life. With the right care, individuals living with foot psoriasis can navigate the condition more comfortably.

psoriasis on feet

What is Psoriasis on the Feet?

Psoriasis on the feet, often referred to by its medical term palmoplantar psoriasis, is a chronic skin condition characterized by the development of red, scaly patches on the soles of the feet and, in some cases, the palms of the hands. This condition is a manifestation of the immune system mistakenly attacking healthy skin cells, leading to rapid cell turnover and the formation of psoriasis plaques.

Not only is foot psoriasis a physical discomfort, but it's also linked to several other health conditions, enhancing its relevance and the need for a comprehensive understanding. Individuals with psoriasis may be at an increased risk of developing inflammatory arthritis, inflammatory bowel disease—particularly Crohn's disease—uveitis (eye inflammation), and celiac disease. Furthermore, severe psoriasis has been associated with higher risks of diabetes and cardiovascular diseases, highlighting the importance of managing psoriasis not just for skin health but for overall well-being.

Types of Psoriasis Affecting the Feet

Psoriasis can manifest in various forms, each with its unique characteristics and impacts on foot health:

  • Plaque Psoriasis on Feet: This is the most common type, affecting about 85 to 90% of people with psoriasis. It appears as raised, red patches covered with a silvery scale, known as plaques, and can cause significant discomfort.
  • Palmoplantar Psoriasis: Specifically affecting the palms and soles, this form of psoriasis is particularly challenging due to the pressure and friction these areas endure. It can lead to deep cracks, soreness, and difficulty with daily activities.

 

Other forms of psoriasis that may affect the feet include:

  • Guttate Psoriasis: Characterized by small, droplet-shaped spots, this type can also appear on the soles and is often triggered by infections.
  • Pustular Psoriasis: A rarer form that leads to pus-filled blisters on the palms and soles, offering a distinct presentation from other types.


Understanding these types is crucial for effective management and treatment. High-quality images can help visually distinguish between these forms, offering a clearer understanding of what each type looks like and how it affects the feet.

Symptoms of Foot Psoriasis

The symptoms of foot psoriasis can vary widely among individuals but commonly include:

  • Red and inflamed patches of skin
  • Silvery scales or plaques on these red patches
  • Dry, cracked skin that may bleed
  • Itching, burning, or soreness around the affected areas
  • Thick, pitted nails, a sign of nail psoriasis
  • Swollen and painful joints, indicative of psoriatic arthritis


It's important to note that symptoms can appear differently across various skin tones. On lighter skin, plaques might appear pink or red, while on darker skin tones, they may look violet, dark brown, or take on a grayish hue.

If you're experiencing symptoms that could be indicative of foot psoriasis or another condition, consider using an online Symptom Checker. While this tool can offer initial insights based on your symptoms, it's not a substitute for professional medical advice. Always consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.

Causes and Triggers

Understanding psoriasis on the feet begins with recognizing it as an autoimmune condition, a scenario where the body's defense system mistakenly attacks its own tissues. In the case of psoriasis, this misguided assault speeds up the skin cell lifecycle, leading to the rapid buildup of cells on the skin's surface. Research points to genetics playing a pivotal role, with certain genes predisposing individuals to this condition. If you have family members with psoriasis, your likelihood of developing it increases, underlining the genetic thread running through this condition.

Common triggers known to provoke or exacerbate psoriasis include:

  • Stress: A well-known catalyst for flare-ups. Managing stress through techniques like mindfulness, yoga, or professional counseling can help mitigate its impact.
  • Infection: Particularly strep throat, which can lead to guttate psoriasis. Keeping good hygiene and seeking timely treatment for infections is key.
  • Skin Injury: Cuts, scrapes, or severe sunburns can trigger the Koebner phenomenon in people with psoriasis. Protecting your skin from injuries and caring for wounds properly can help prevent this.
  • Certain Medications: Some drugs can worsen psoriasis symptoms. If you notice changes after starting a new medication, consult with your healthcare provider for alternatives.
  • Weather Changes: Cold and dry conditions often lead to flare-ups. Keeping your skin moisturized and using a humidifier during dry months can offer relief.

Diagnosis Process

Physical Examination

The journey to diagnosing psoriasis on the feet typically starts with a thorough physical examination. Healthcare professionals look for distinctive signs of psoriasis, such as raised, red patches of skin adorned with silvery scales, and may also inspect for nail changes or joint inflammation. This initial assessment often involves a detailed discussion about your medical history and any familial occurrence of psoriasis, which aids in distinguishing psoriasis from other skin conditions with similar symptoms.

Family and Medical History

A crucial component of the diagnostic process involves understanding the patient's medical and family history. Given the genetic factors associated with psoriasis, knowing whether close relatives have experienced similar symptoms can be a significant clue in confirming the diagnosis. Additionally, discussing your personal medical history helps healthcare providers identify any potential triggers or related health conditions that might influence your psoriasis.

Biopsy

In cases where the diagnosis isn't immediately apparent or to exclude other conditions like eczema or fungal infections, a skin biopsy may be performed. This minor procedure entails removing a small sample of skin for laboratory examination. The biopsy can reveal the overactive skin cell production characteristic of psoriasis and rule out other diseases, providing a clear path towards accurate diagnosis and appropriate treatment.

Comprehensive Treatment Options

Managing psoriasis on the feet involves a multifaceted approach tailored to the severity of the condition and individual patient needs. Treatment options range from simple home remedies to advanced medical interventions.

Home Remedies

Home management strategies form the foundation of psoriasis care, emphasizing symptom relief:

  • Moisturizing: Regular application of heavy creams and ointments can keep the skin hydrated, reducing itching and scaling.
  • Cool Compresses: Applying cool, wet cloths to the affected areas can soothe irritation and alleviate inflammation.

Topical Treatments

For many, topical medications are the first line of defense against foot psoriasis:

  • Corticosteroids: Reduce inflammation and slow down skin cell turnover.
  • Vitamin D Analogues: Help normalize skin cell activity.
  • Coal Tar: Reduces scaling, itching, and inflammation, though its messy application makes it less favored by some.

Systemic Treatments

Systemic medications are considered for moderate to severe psoriasis or when topical treatments prove ineffective:

  • Oral Retinoids: Work by slowing down the skin cell growth cycle.
  • Immunosuppressants: Reduce the immune system's activity to prevent the overproduction of skin cells.
  • Biologics: Target specific parts of the immune system to block the overactive immune response causing psoriasis.

Phototherapy

Phototherapy or light therapy involves exposing the skin to ultraviolet light under medical supervision, helping to slow skin cell turnover and reduce scaling and inflammation.

Innovative Treatments

Recent advancements in treatment options include new biologic drugs and small molecule inhibitors, offering hope for those who haven't found relief with traditional therapies. Personalization of treatment plans based on genetic markers is also on the horizon, promising more targeted and effective care.

 

Navigating the complexities of psoriasis, especially when it manifests on the feet, often necessitates professional guidance. A podiatrist or dermatologist specializes in diagnosing and managing skin conditions like psoriasis and can offer insights that are tailored to your specific situation. These professionals can help determine the most effective treatment plan, which may include a combination of therapies to manage symptoms and improve your quality of life.

Living with Psoriasis on the Feet: Lifestyle Tips and Tricks

Adopting a holistic lifestyle can significantly impact the management of foot psoriasis, enhancing treatment efficacy and improving quality of life.

  • Dietary Adjustments: Incorporating anti-inflammatory foods such as fatty fish, leafy greens, and nuts can support overall health and potentially reduce psoriasis flare-ups.
  • Stress Management: Techniques like meditation, yoga, or therapy can mitigate stress, a known trigger for psoriasis symptoms.
  • Foot Care: Gentle daily cleansing, avoiding harsh soaps, and wearing breathable footwear can protect sensitive skin on the feet from irritation.
  • Exercise: Regular, low-impact activities help maintain joint flexibility and reduce stress but avoid activities that may injure the feet.
  • Avoid Triggers: Recognize and steer clear of personal triggers, whether they're environmental factors, certain foods, or stressors.

Psoriasis on Feet vs. Athlete's Foot

When dealing with foot discomfort, distinguishing between psoriasis on the feet and athlete's foot is crucial for effective treatment. Though they share some superficial similarities, understanding their differences is key to managing each condition properly.

Similarities:

  • Itchiness and Discomfort: Both conditions can cause significant itchiness and discomfort, making it challenging to walk or wear shoes comfortably.
  • Appearance on Feet: Each can manifest on the soles, sides, or in between the toes, with symptoms that affect the skin's appearance and texture.

 

Differences:

  • Cause: Psoriasis is an autoimmune condition leading to overproduction of skin cells, resulting in thick, scaly patches. Athlete's foot, however, is a fungal infection that thrives in moist environments, leading to a rash that can crack and peel.
  • Symptom Appearance: Psoriasis patches are well-defined, raised, and covered with silvery scales. Athlete's foot tends to produce a scaly rash that may blister and crack, often starting between the toes.
  • Treatment: Treatment for psoriasis focuses on managing symptoms and may include topical treatments, light therapy, and systemic medications. Athlete's foot is treated with antifungal medications aimed at eliminating the infection.

Conclusion

Psoriasis on the feet can be more than just a physical ailment; it can affect your mobility, comfort, and lifestyle. Understanding the condition, recognizing its symptoms, and being aware of the comprehensive treatment options available are the first steps toward management. Remember, while lifestyle adjustments and home remedies play a crucial role in managing psoriasis, professional care is invaluable for a tailored treatment approach and improved outcomes. By taking action and seeking expert advice, you can navigate the challenges of psoriasis with confidence.

Frequently Asked Questions

What Are Some Effective Home Remedies for Psoriasis on the Feet?

Effective home remedies include regularly moisturizing with thick, fragrance-free creams to keep skin hydrated, applying cool, wet compresses to soothe inflammation, and soaking feet in lukewarm water with oatmeal or Epsom salts to relieve soreness and gently remove scales.

How Can I Tell if It's Psoriasis on My Feet or Athlete's Foot?

Psoriasis on the feet typically presents as raised, red patches covered with silvery scales, often affecting the soles or sides of the feet. Athlete's foot usually appears as a scaly rash that leads to itching, stinging, and burning, primarily between the toes. Psoriasis patches are thicker and more defined than the rash caused by athlete's foot.

What Characterizes Plaque Psoriasis on the Feet?

Plaque psoriasis on the feet is characterized by raised, red patches of skin covered with a silvery scale, appearing on the soles or other parts of the feet. These patches can be itchy, painful, and may crack and bleed in severe cases.

Why Is Psoriasis on the Feet a Concern?

Psoriasis on the feet is a concern because it can lead to significant discomfort, making walking and standing painful. It can also increase the risk of infection in cracked skin and significantly impact a person's quality of life.

What Is Palmoplantar Psoriasis, and How Does It Affect the Feet?

Palmoplantar psoriasis is a type of psoriasis that specifically affects the palms of the hands and the soles of the feet. It manifests as red, scaly patches that can crack and become painful, significantly affecting mobility and daily activities.

What Should I Know About Managing Foot Psoriasis?

Managing foot psoriasis involves a combination of treatments to reduce symptoms and prevent flare-ups. This can include topical treatments, phototherapy, and systemic medications, along with lifestyle changes such as stress management and regular skin moisturization. It's important to work with a healthcare provider to develop a tailored treatment plan.

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