Question: I have psoriasis on the bottom of my foot, and the dermatologist had no solution other than a lubricant to keep the skin softer. What do you suggest?

Dr. Hibberd's Answer:

Psoriasis that is limited to a very small area of the plantar (bottom) surface of the foot is most often managed conservatively. Does your doctor know you want more done? Have you discussed treatment options? If you have, and you are still not satisfied, obtain a second opinion from another dermatologist and confirm the diagnosis. Speak up! Only then can your doctor tailor the treatment to your lifestyle.

Topical steroids may be used to treat psoriasis. Psoriasis usually affects the extensor surfaces (the skin on the opposite side of a joint, such as an elbow). It tends to be symmetrical, and responds very well to topical steroid preparations and topical tar preparations.

More extensive involvement will be treated by phototherapy and immune suppressants. Since the bottom of your foot is involved, you could have a form of pustular psoriasis that tends to be more resistant to treatment and is usually aggressively treated until it goes into remission.