PMC3912797_01
Chronic plaque psoriasis over left palm and right sole that has evolved from palmoplantar pustulosis (a) note plantar pustulosis lesions (b) similar lesions were present over other palm/sole
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F1
However, his skin lesions progressed relentlessly eventuating into palmoplantar psoriasis with pustulosis [Figure 1].
Histopathology of a plantar lesion showing hyperkeratosis, parakeratosis, acanthosis, papillomatosis and neutrophils in dermal papillae (inset) (H and E, x10, Inset, x40)
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F2
A skin biopsy from a pustular lesion showed hyperkeratosis, parakeratosis, acanthosis, papillomatosis and papillary neutrophilic collection suggestive of psoriasis having pustular differentiation [Figure 2].