title: Palmoplantar psoriasis: a phenotypical and clinical review with introduction of a new quality-of-life assessment tool.
abstract: BACKGROUND
  Palmoplantar psoriasis is associated with significant quality-of-life issues. Its epidemiology and phenotypical expression remain ill defined.
  
  
  OBJECTIVE
  We reviewed the literature and our clinical experience and developed a new quality-of-life assessment tool.
  
  
  METHODS
  We conducted a retrospective review of 150 patients with palmoplantar psoriasis.
  
  
  RESULTS
  In all, 78 (52%) patients displayed predominantly hyperkeratotic palmoplantar lesions, 24 (16%) pustular, 18 (12%) combination, and 30 (20%) had an indeterminate phenotype. In 27 (18%) patients, lesions were confined to the palms and soles. A new quality-of-life index was constructed to characterize disease severity. In all, 27 (18%) had mild, 72 (48%) moderate, and 51 (34%) severe disease involvement. Palmoplantar disease severity appeared independent from the degree of body surface area involvement.
  
  
  CONCLUSIONS
  This was a retrospective review. The quality-of-life index remains to be statistically verified in prospective clinical studies.
  
  
  CONCLUSIONS
  Defining morphologic subtypes together with the use of a specific quality-of-life assessment tool in patients with palmoplantar psoriasis will improve our understanding and treatment of this recalcitrant form of psoriasis.
authors.affiliation: Baylor University Medical Center, Dallas, Texas, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Farley
authors.forename: Shamin
authors.initials: S
authors.lastname: Masrour
authors.forename: Joanna
authors.initials: J
authors.lastname: McKey
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
mesh_terms: D005533:Foot Dermatoses / Q000503:physiopathology*; D006229:Hand Dermatoses / Q000503:physiopathology*; D006801:Humans; D010641:Phenotype; D011565:Psoriasis / Q000503:physiopathology*; D011788:Quality of Life; D012189:Retrospective Studies