Analysis of misdiagnosis causes of palmoplantar pustulosis

MA Xueying; ZHAO Yuanying; LAN Hailong; ZHOU Jing; WANG Zhengxiang

doi:10.3969/j.issn.1002-3429.2025.21.004

Abstract：Objective To explore the causes of misdiagnosis and preventive measures of palmoplantar pustulosis(PPP).Methods The clinical data of 14 patients with PPP who were previously misdiagnosed and admitted from January 2021 to January 2025 were retrospectively analyzed.Results Fourteen patients were misdiagnosed,including 4 patients misdiagnosed with skin infection,who had erythema,pustules with slight erosion and exudation on the skin lesions of fingers or feet to form pus.In addition,2 patients misdiagnosed as psoriasis;the distal joint swelling of both hands was accompanied by yellow pustules,the skin rash was gradually increased,and the joint swelling and deformity appeared.Six patients misdiagnosed as eczema had main symptoms,including scattered red patches on the palms and soles,accompanied by small blisters or exudate.The clinical manifestations of 2 patients misdiagnosed as tinea manus and pedis were blisters,desquamation,itching,skin thickening or chap on the fingers or toes,and the improvements of symptoms after corresponding intervention were not obvious.All 14 patients were diagnosed as PPP after pathological examination,with the misdiagnosis duration of 4 months to 12 years.After confirmed diagnosis,the symptoms were significantly improved after treatment with drugs such as Ixekizumab injection.Follow-up for 6 months to 3 years revealed that the skin lesions and clinical symptoms of the above-mentioned patients had disappeared.Conclusion The incidence rate of PPP is low,and its clinical manifestations are not typical.Clinicians need to fully grasp the clinical characteristics and key diagnostic points of the disease,and be vigilant to reduce or avoid misdiagnosis.