ABSTRACT
A 37-year-old man with a history of chronic stable plaque psoriasis fractured both hands during a fall on his outstretched hands. Ten days later, following surgery and the application of tight fitting orthopaedic hand splints, the splints were removed because of a 7-day history of painful and pruritic palms. It was evident that the injury to his hands and the firm application of his splints had resulted in a dramatic flare of his psoriasis. This manifested in two clinical forms that he had not developed previously. He had a strikingly symmetrical palmar keratoderma that had köbnerized maximally in the regions where the splints apposed his palms firmly. In addition, he had pustular psoriasis affecting the fingertips of both hands. After removal of the splints he responded to a combination of oral acitretin, and 6% coal tar and 6% salicylic acid in aqueous cream applied topically.
Subject(s)
Keratoderma, Palmoplantar/diagnosis , Keratoderma, Palmoplantar/etiology , Psoriasis/complications , Splints/adverse effects , Adult , Hand Injuries/surgery , Humans , Keratoderma, Palmoplantar/drug therapy , Keratoderma, Palmoplantar/pathology , Keratolytic Agents/administration & dosage , Male , Psoriasis/drug therapy , Salicylic Acid/administration & dosage , Treatment OutcomeABSTRACT
A 71-year-old Cambodian man who was commenced on allopurinol for the treatment of gout developed a generalized papulopustular follicular eruption 8 weeks following introduction of the drug. The skin biopsy findings were consistent with that of eosinophilic pustular folliculitis. Resolution of the rash took place during the 8 weeks following cessation of allopurinol and treatment with oral and topical corticosteroids.
