Psoriasis is a skin condition that causes an itchy, scaly rash and can occur on any part of the body including the feet. Psoriasis on the heels of the feet is known as palmoplantar psoriasis. This type of psoriasis affects the palms of the hands and the soles of the feet, two areas on the body that naturally have thicker skin for protection. Psoriasis is categorised as an immune-mediated disease that causes skin cells to grow and multiply abnormally resulting in inflammation in the body. Psoriasis is a chronic disease with no known cure, and may lead to other health issues such as psoriatic arthritis.
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Symptoms
Psoriasis on the heels is sometimes confused with a fungal infection as both cause a similar rash that is often itchy. Psoriasis on the heels of the feet will present as slightly raised, red and inflamed patches with silvery scales or plaques on top. The plaques can be quite thick and dry and may cause the skin to crack and bleed. The skin on the heels endures a considerable amount of body weight and impact during gait. Cracks in the skin will cause pain and discomfort and will increase the risk for infection and subsequent complications.
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Causes
The cause of psoriasis is not clear but the immune system and genetics both play a role in its development. Trigger events such as stress, injury to the skin, weather, illness, allergies, food, alcohol or the environment may alter the immune system leading to symptoms of psoriasis. Stress is one of the most common triggers of psoriasis and psoriasis may also lead to increased stress. Scratches and bug bites injure the skin and could lead to a flare-up in psoriasis as can the colder weather months which have less sunlight and humidity.
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Treatment
There is no known cure for psoriasis therefore the goal of treatment is symptom management achieved by stopping skin cells from growing so quickly and removing scales caused by psoriasis. It is best to use a mild and fragrance-free soap when washing feet and apply moisturiser daily to maintain the health of the skin. Topical creams and ointments containing corticosteroids, retinoids or coal tar will help with inflammation and scaling as will natural or artificial light therapy. Oral or injected medications may be required if other treatments are not effective. Stress management can help reduce the frequency of psoriasis flares. Seeing a medical footcare clinician on a regular basis will keep thickened skin on the heels under control.
