Experience

Palmoplantar pustulosis for 1 year and 4 months

Palmoplantar pustulosis for 1 year and 4 months/man in his 60s

It initially developed with a small number of reddish bumps on the palm of my left hand. I took over-the-counter steroid ointmenttablets , and observed. The skin started peeling, and the number of bumps increased. Therefore, I went to the dermatology department of my regular hospital. Peeling skin was examined with microscope, and was found to be sterile. Although a topical ointment was prescribed, the symptoms were aggravated. I visited the hospital again.
I was subsequently diagnosed with palmoplantar pustulosis, and was given a leaflet. I was told that causes of palmoplantar pustulosis were unknown and it would take 3 to 7 years for palmoplantar pustulosis to resolve.
Symptoms were aggravated, thereafter. Bumps were observed also on the soles of my feet, and skin peeling became severer. Then I decided to change the doctor, and found my current dermatologist. The first thing I was told by the new doctor was to take dental X-rays.
Then X-ray images as well as the one taken 10 years ago. The new doctor immediately spotted a lesion in the apical area of a tooth. I was told to have it removed, and underwent removal of the dental apical lesion.
I was told that symptoms would aggravate temporarily for 2 weeks after the surgery but would improve about 6 months later if the dental apical lesion was the cause of your palmoplantar pustulosis. The clinical course was being followed up.
After the surgery, the symptoms were aggravated as expected. Nail plates turned yellowish, became swollen and cracked. It was painful. Bumps were also observed over the whole body including the face and head. That proved that the dental lesion was the cause of palmoplantar pustulosis.
Symptoms were the severest during that time. However, bumps (papules and pustules) over the whole body gradually disappeared, and symptoms on the palms of the hands and soles of the feet improved as well. Not all the symptoms had resolved yet, but removal of the dental lesion was proven to be effective. I am still continuing with topical and oral treatments.
Palmoplantar pustulosis is considered to be a cause of outburst of autoinflammatory immune system (the trigger of outburst have not been specifically identified because various factors are involved, but a long-standing dental apical lesion is considered to be one of the causes). Accordingly, studies on roles of cytokines like IL-23, and related immune cells like Th17 cells had huge development in recent years.
A biologics suppressing the outburst immune system was developed in the United States, and its use was approved in Japan as well.
I was actually looking forward to this treatment, but unfortunately I can not take the shots of this this biologics due to findings of blood tests. So I have no choice but to continue the current
treatment until it will be cured.
I suspect that these cells activities are influenced by foods as such cells are also activated in the intestine.
We say “you are what you eat”. There is no scientific proof, but I believe food is somewhat involved in onset of autoinflammation provocation.
We launched this website in the hope that not only patients with palmoplantar pustulosis but also for physicians to provide treatments with accurate knowledge of the disease.
Since shoulder pain or lower back pain can be sometimes initial symptoms of palmoplantar pustulosis, it may be necessary to coordinate with orthopedists if you have such pains. .
Palmoplantar pustulosis is a relatively rare disease with less than 150,000 patients in Japan. Therefore, there are only a few dermatologists specialized in treating this disease. However, I still hope for other dermatologists (not specialized in palmoplantar pustulosis) to be actively engaged in treatments with accurate knowledge of the disease because just handing out a leaflet is not going to help patients.

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