palmoplantar pustulosis
Introduction
Introduction to palmoplantar pustulosis Pustulosis palmariatplantaris (pustulosispalmarisetplantaris) is a chronic recurrent pustular skin disease located in the palmar area. Histology is characterized by epidermal vesicles and a large number of neutrophils. A periodic aseptic small pustule with keratinization and scaly as a clinical feature appears on the basis of erythema. Occurs in 50 to 60 years old, women are more common in men. Poor response to treatment. basic knowledge The proportion of illness: the incidence rate is about 0.002%-0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: impetigo
Cause
The cause of psoriasis
Allergies (30%):
Metal allergy is actually an allergy to metal "nickel". In addition to gold and silver jewellery, all kinds of metal jewellery will contain this metal component more or less, especially those cheap 925 silver or Tibetan silver. There is a cheap silver jewelry with a bright appearance. Such as contact with metal-containing foods or metal dental materials.
Infection factor: (30%):
In some patients, the pathogens such as bacteria, viruses, fungi, and parasites invade the human body, causing local tissue and systemic inflammatory reactions, and inducing palmoplantar pustulosis such as inflammation of the tonsils.
Smoking (15%):
Smoking can also be a cause of palmoplantar pustulosis.
Pathogenesis
Some authors believe that the imbalance of skin protease and anti-protease system, leading to the decline of anti-leukocyte protease activity in abscess psoriasis, may be one of the mechanisms of pustule formation, a long-term study from Japan found that the disease and a large number of smoking , tonsillitis, seasonal factors such as high humidity and high temperature.
Prevention
Palmoplantar pustulosis prevention
1, avoid smoking, diet should be light, temperament and irritability and excessive fatigue.
2. Actively eradicate infected lesions. Prevent infection by pathogens such as bacteria, viruses, fungi, and parasites.
3, in the life to avoid contact with metal jewelry, to prevent contact with the metal "nickel" in jewelry and allergies.
Complication
Palmoplantar pustulosis complications Complications, impetigo
Impetigo.
Symptom
Palmoplantar pustulosis symptoms Common symptoms Itching skin mild sputum red blister pustule scales
The female is more than male, the ratio of male to female is 1:3, most often between 20 and 60 years old, 10% of patients before the age of 20, about 24% have a family history of psoriasis.
Primary lesions are pustules of almost the same size, with a diameter of 2 to 4 mm. Groups of lesions often appear in the palmar skin with normal appearance within a few hours. There is a red halo around the pustules. The best hair is the palm. Hey, the crotch is more common than the palm. The palm is good for the palm of the thumb and the center of the palm. The crotch is most common with the arch. In addition to the palm, the back, calves, knees, back of the hand, elbows, etc. There may also be skin lesions. The color of the skin lesions changes from yellow to dark brown with time. After 5-7 days, the pustules are absorbed. The epidermis thickens and hardens, loses elasticity, is flaky scales, and the surrounding free center is fixed. There is a cleft palate in the center. After the epidermis is detached, there is a red and thin epidermis underneath. When the lesion is severe, it is punctate and erosive. The exudate is more, similar to eczema. It lasts for several weeks to several months. Only the blisters around the epidermis occur. The length of the period varies, various external stimuli (such as soap lotion, topical irritant drugs, increased sweating in summer), premenstrual autonomic dysfunction, etc. can promote the onset of the disease, the symptoms worse.
The test showed that the pus bacterial culture was negative, the blister blister phase was dominated by monocytes, and the pustule stage was mainly neutrophils.
Examine
Examination of palmoplantar pustulosis
The test showed that the pus bacterial culture was negative, the blister blister phase was dominated by monocytes, and the pustule stage was mainly neutrophils.
Histopathology: single atrial pustule in the epidermis, a large number of polymorphonuclear neutrophils in the cavity, the surrounding epidermis is spongy, can see dense accumulation of neutrophils in the stratum corneum, around the superficial blood vessels of the dermis Monocytes and neutrophil infiltration can be seen.
Diagnosis
Diagnosis and differentiation of palmoplantar pustulosis
According to middle-aged women, pustules appear repeatedly on the erythema of the palm of the hand, with varying degrees of itching, and histopathology is not difficult to diagnose in the epidermis.
Differential diagnosis
1. Swollen eczema-like dermatitis: Especially when secondary infection forms pustular lesions, however, most of the blisters in this disease are clear and transparent.
2. Continuous acral dermatitis: often at the end of the toe or a week with a grooved tongue, Kogoj spongy pustules in the epidermis.
3. Pustular bacterial rash: There are often infected lesions, or pustules disappear with antibiotics.
