Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
Tags: psoriasis | feet | treatment | tar | salicylic | acid | corticosteroids

How Can I Treat Psoriasis on Feet?

Monday, 24 Sep 2012 09:22 AM

Question: I have psoriasis in an odd place, on the bottom of my feet. I tried UV light treatments without getting relief. Any treatment suggestions?

Dr. Hibberd's answer:
Acute flares of psoriasis on the feet need to be promptly and carefully treated. In some cases, cracking, blisters, and swelling accompany flares. The National Psoriasis Foundation recommends initial topical treatment of palm and sole psoriasis with tar, salicylic acid, and corticosteroids. Combinations of these three agents may work better than using each individually. Moisturizers, mild soaps, and soap substitutes also are available and often used with success.
Calcipotriene (Dovonex, Calcitrene, Sorilux) can also be effective to treat psoriasis on hands and feet.
Wear cotton gloves so the medicine doesn't get on sensitive skin sites, such as the face or skin folds.
A regimen alternating calcipotriene and potent topical corticosteroids may be helpful.
If topical medications do not work, your doctor may recommend methotrexate, cyclosporine, or Soriatane (acitretin).
Methotrexate can clear many cases of palm and sole psoriasis within four to six weeks. Combining low doses of oral retinoids with UVB or PUVA might also be effective with reduced side-effects.
Consider a consultation with your primary care physician and a consultation with a dermatologist also. Psoriasis is an immune-mediated condition with other destructive effects on joints and other tissues that should be aggressively treated and prevented. We have excellent agents now for disease remission, so do not self treat this condition without professional guidance.



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