The ‘Heartbreak’ of Psoriasis – Palmar-Plantar Pustulosis

Way back when, there was a commercial for some product (I want to say that it was Gold Bond something) that helped with the ‘heartbreak of psoriasis’. I remember snickering at that commercial. The ‘heartbreak’ of psoriasis? A little dramatic, don’t you think?

Well, I’m not sure that my psoriasis has caused me ‘heartbreak’, exactly, but it has certainly given me enough headaches.

I have a rare form of psoriasis known as Palmar-Plantar Pustulosis (or Palmoplantar pustulosis). Of course, it is wonderful having a disease that uses the word ‘pus’ in it somewhere. Nothing icky about that. Unfortunately, it is accurate. This particular variety of psoriasis involves little pustules that are mostly located on the palms of the hands and on the soles of the feet. I will avoid medical terminology for the moment, and just describe how this nasty stuff works on me. First I erupt in tiny little pustules. I, personally, pop the little suckers as fast as I can, because otherwise they itch like crazy. Just so you know – I have tried not popping them, and it really makes no difference in how this stuff plays out. The only difference is that it doesn’t itch as badly. Anyhow, it then moves into causing my feet to be so dry that they crack wide open. Every step that I take painfully pulls on these cracks. Simplistically, it is ugly, and it hurts. And there is no cure.

When I first began to suffer from Palmar-Plantar Pustulosis, about fifteen years ago, I went through the entire routine of treatments. I tried lotions and creams, I tried steroids, I tried UVA light treatments. Nothing helped. When my dermatologist wanted to try me on Cyclosporine – as something of a last resort – I took one look at the possible side effects and decided that I could live with my problem.

And I have lived with it. Palmar-Plantar Pustulosis tends to run in cycles. I will have it actively for three to five years, and then I will go into remission for a couple of years. Remission seems to last just long enough for my skin to totally heal before it starts to take another beating.

For a long time, I was really focused on what caused it to flare. I have had several doctors for this problem, and each of them have wanted to – primarily – blame stress. Truthfully, I have seen no correlation between stress and my PPP. Yes, I have had had breakouts when I was really stressed. But some of the most stressful times of my life have been PPP free. Weather also seems to make no real difference. It’s been bad in the winter, and it has been bad in the summer.

I have spent many hours on the internet, trying to find out whether or not anyone has had any real luck in dealing with this condition. From what I have read, the best possibility is a short-term fix by taking oral medications. The problem with oral medications – such as cyclosporine – is that they are very short-term, and often have side effects that are worse than the original problem. And once the sufferer goes off of the medication – and all of these medications have limits to how long they may be taken – then the condition comes right back.

So for now, I simply live with it. Sometimes PPP leaves me alone, sometimes it beats the heck out of me. I figure it could be worse.