Palmoplantar pustulosis

Japanese: 掌蹠膿疱症 - しょうせきのうほうしょう（英語表記）Palmoplantar pustulosis
Palmoplantar pustulosis

What is the disease?

It is a chronic disease that develops sterile pustules (a pus-filled skin rash) on the palms and soles of the feet. Desquamation ( Easy ) There are many pustules on the affected areas. Think of this as a disease in which pustules appear on the palms of the hands and soles of the feet, even though there are no bacteria or viruses present.

What is the cause?

It is currently unknown. psoriasis ( infection ) The prevailing view is that it is a subtype of

In Japan, it is considered unrelated to psoriasis, and some believe that the cause is focal infection or metal allergy.

This is a disease that is common among smokers.

How symptoms manifest

Pustules appear on the palms of the hands and the soles of the feet (especially the arches) and are surrounded by redness. The redness sticks together and the entire palms and soles of the feet become peeling and red, with pustules and scabs visible inside.

Testing and diagnosis

A specialist can make a definitive diagnosis based on the characteristic clinical features, fungi ( Shinkin ) Tests (for athlete's foot) may be performed, and if the condition is unclear, a skin sample may be taken and examined under a microscope (skin biopsy).

Treatment methods

Treatments include topical application of steroid medication, oral etretinate (Tigason), oral immunosuppressant medication (Neoral), and ultraviolet light therapy, but it is difficult to cure the disease in a short period of time.

What to do if you notice an illness

Try to quit smoking. Another option is to have the infected area removed. Tonsils ( Tonsil ) A test called induction is performed, and if the result is positive, the tonsils are removed. Also, a metal allergy test is performed, and if the result is positive, removal of dental metals may be considered.

Toshihiro Tanaka

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　手のひらや足の裏に無菌性の膿疱（うみをもった皮疹）が生じて慢性の経過をたどる病気です。完成像は、境界がはっきりした紅斑落屑(らくせつ)局面に多数の膿疱をもちます。ばい菌やウイルスがついていないのに、手のひらや足のうらに膿疱ができる病気と考えてください。

原因は何か

　現在のところは不明です。欧米では、乾癬(かんせん)の一亜型とする考え方が有力です。

　日本では乾癬とは無関係で、病巣感染や金属アレルギーを原因として重視する考え方もあります。

　喫煙者に多い病気です。

症状の現れ方

　手のひらや足の裏（とくに土踏まずの部分）に膿疱ができ、周囲に赤みをもつようになります。赤みはお互いにくっつき合って、手のひらや足の裏全体の皮がむけて赤くなる状態になり、そのなかに膿疱やかさぶたが見えるようになります。

検査と診断

　専門医が見れば特徴的な臨床像から確定診断ができますが、真菌(しんきん)検査（水虫の検査）や、わかりにくい時は皮膚をとって顕微鏡で調べる検査（皮膚生検）を行うこともあります。

治療の方法

　ステロイド薬の外用、エトレチナート（チガソン）の内服、免疫抑制薬（ネオーラル）の内服、紫外線療法などがありますが、短期間での根治は難しい病気です。

病気に気づいたらどうする

　禁煙を心がけます。感染病巣の摘出という手段もあります。耳鼻科で扁桃(へんとう)誘発という試験をして、陽性ならば扁桃腺を摘出します。また、金属アレルギーの検査を行って、陽性であれば歯科金属の除去を考えることもあります。

田中　俊宏

出典　法研「六訂版 家庭医学大全科」六訂版 家庭医学大全科について　情報

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