Baptista Marta N, Cardoso Pedro D, Sousa Sara D, Ribeiro Ricardo
Family Medicine, Unidade de Saúde Familiar, Unidade Local de Saúde de Braga, Braga, PRT.
Cureus. 2024 Nov 30;16(11):e74864. doi: 10.7759/cureus.74864. eCollection 2024 Nov.
Plantar psoriasis is a chronic inflammatory skin disorder, typically characterized by erythematous plaques with thick silvery scales localized on the soles. This condition can significantly impair patients' quality of life, particularly through pain and mobility challenges. It is considered a subtype of plaque psoriasis but presents unique diagnostic and therapeutic challenges due to its specific location. We report the case of a 44-year-old female with bilateral burning and scaling of the feet, initially misdiagnosed and treated for fungal infections without success. Despite persistent symptoms, a dermatological consultation was delayed for three years. Upon reassessment, she presented with scaly lesions on the elbows and feet. Treatment with topical betamethasone and calcipotriol led to partial resolution of plantar lesions but not the elbow lesions. Following a comprehensive evaluation, the patient was diagnosed with plantar psoriasis and maintained on topical therapy, avoiding systemic treatments. Her management highlights the importance of accurate diagnosis and timely specialist referral. This case illustrates the challenges in diagnosing plantar psoriasis, particularly when overlapping with other dermatological conditions. A conservative treatment approach with topical steroids proved effective in managing symptoms. The patient's delayed referral underscores the need for prompt specialist care to mitigate prolonged discomfort. Additionally, comorbidities like anxiety and depression may exacerbate the patient's symptoms, emphasizing the importance of integrated care that addresses both physical and psychological aspects. This case emphasizes the necessity of timely and accurate diagnosis, early referral for specialist care, and a multidisciplinary management approach for chronic dermatological conditions such as plantar psoriasis. Further research is warranted to explore the interplay between psychological factors and dermatological conditions to improve patient outcomes.
足底银屑病是一种慢性炎症性皮肤病，其典型特征是足底出现伴有厚层银色鳞屑的红斑斑块。这种疾病会显著损害患者的生活质量，尤其是在疼痛和行动不便方面。它被认为是斑块状银屑病的一种亚型，但由于其特定的发病部位，在诊断和治疗上存在独特的挑战。我们报告了一例44岁女性患者，其双脚出现双侧烧灼感和脱屑，最初被误诊为真菌感染并接受治疗，但未成功。尽管症状持续存在，但皮肤科会诊却延迟了三年。重新评估时，她的肘部和足部出现了鳞屑性皮损。外用倍他米松和卡泊三醇治疗使足底皮损部分消退，但肘部皮损未消退。经过全面评估，该患者被诊断为足底银屑病，并继续接受局部治疗，避免全身治疗。她的治疗过程凸显了准确诊断和及时转诊至专科医生的重要性。这个病例说明了诊断足底银屑病的挑战，尤其是当它与其他皮肤病况重叠时。外用类固醇的保守治疗方法被证明对控制症状有效。患者转诊延迟凸显了及时获得专科护理以减轻长期不适的必要性。此外，焦虑和抑郁等合并症可能会加重患者的症状，这强调了综合治疗身体和心理方面的重要性。该病例强调了及时准确诊断、尽早转诊至专科护理以及对足底银屑病等慢性皮肤病采用多学科管理方法的必要性。有必要进行进一步研究，以探索心理因素与皮肤病况之间的相互作用，从而改善患者的治疗效果。
