This article addresses the diagnostic challenges of palmoplantar dermatoses (PPD) within the scope of Primary Health Care (PHC). These common skin conditions, encountered in daily practice, exhibit a diverse range of symptoms and morphologies, complicating their diagnosis. They are etiologically classified into infectious inflammatory, non-infectious inflammatory, and hereditary keratodermas. While various dermatoses may affect the palms and soles, few are specific to this area. Notable examples include palmoplantar pustulosis, dyshidrosis, erythema pernio, and Bazex syndrome. Given the high prevalence of dermatological consultations in PHC, this article underscores the significance of PHC professionals\' knowledge regarding these conditions. It proposes a diagnostic algorithm to facilitate their management and timely referral.

Introduction Palmoplantar dermatoses are skin diseases affecting specifically palms and soles is a common clinical entity encountered by dermatologists. This may cause discomfort and embarrassment to the patients because its location interferes significantly with normal day-to-day activities. Palmoplantar dermatosis affects a heterogeneous population, ranging from bare-handed workers in the slaughterhouse to medical personnel wearing gloves in the operating room. The present study endeavors to classify palmoplantar dermatoses based on their morphology and the clinical distribution pattern. Materials and methods The present study is a descriptive cross-sectional study conducted for six months at Osmania General Hospital, India. A total number of 80 patients having palmoplantar dermatoses who met the study inclusion criteria were included. After taking proper informed consent, data were collected from patients on a fixed proforma sheet. Results The study comprised 44 (55%) male and 36 (45%) female patients. The mean duration of palmoplantar dermatoses was 2.92 years. Itching and painful fissures are the most common symptoms patients complained of and psoriasis is the most common clinical type seen in 32 (40%) patients followed by eczemas in 30 (37.5%) patients and fungal infections in 10 (12.5%) patients. Conclusion The term palmoplantar dermatoses includes a heterogeneous group of skin disorders but no exact classification is present and classes differ based on the diseases to be kept in a group. Physicians should be well aware of the clinical features of these dermatoses and diagnosis is very important for early intervention and correct management, thereby helping improve patients\' quality of life.

UNASSIGNED: Palmoplantar dermatoses are commonly found in dermatological practice. Quality of life (QOL) is severely impaired if these areas are affected. Early and appropriate management of palmoplantar dermatoses help in improving patient\'s QOL.
UNASSIGNED: To assess the impact of palmoplantar dermatoses on QOL.
UNASSIGNED: Patients with palmoplantar dermatoses with or without other body part involvement were enrolled in the study. QOL was assessed by Dermatology Life Quality Index (DLQI) questionnaire for >16 years of age and by Children\'s Dermatology Life Quality Index (CDLQI) questionnaire for 5-16 years of age.
UNASSIGNED: Two hundred and two patients participated, of which 108 (53.46%) were males and 94 (46.53%) were females. The commonest age group affected was 17-40 years (42.57%). Housewives 61 (30.2%) and laborers 53 (26.2%) were most common occupational group affected. The mean DLQI and CDLQI scores were 7.68 and 7.46, respectively. Fifty-seven (28.21%) patients had palmoplantar psoriasis (PPP), 35 (17.32%) had palmoplantar keratoderma (PPK), and 26 (12.87%) had hand eczema (HE) with mean DLQI scores 8.60, 8.53, 8.60, and CDLQI scores 8.40, 8.28, and 8.26, respectively. In both DLQI and CDLQI, questions on symptoms and feelings scored maximum. Gender, age, occupation, duration, progress, and type of dermatosis did not show statistically significant association with DLQI. However, chronic recalcitrant dermatoses such as PPP, PPK, and HE showed significant impairment in QOL in relation to occupation and duration of disease.
UNASSIGNED: Severity of various palmoplantar dermatoses was not graded and therefore relation between severity of various dermatoses and QOL was not established.
UNASSIGNED: Majority of patients with palmoplantar dermatoses especially those having chronic course had significant impairment in their QOL.

BACKGROUND: Dermatoses affecting palms and soles are among the most difficult of all dermatological therapeutic problems. Many previous studies have focused on the specific diseases of palmoplantar dermatoses. However, none of them have included a comprehensive study of palmoplantar dermatoses.
OBJECTIVE: To study the epidemiological aspects like age distribution, sex distribution, the dermatoses affecting the palms & soles and the frequency of involvement of palms, soles or both palms & soles, in patient with palmoplantar dermatoses.
METHODS: This cross sectional study was conducted in the Department of Dermatology between October 2011 to September 2013. First 300 cases attending the department of dermatology primarily with complaints pertaining to palms and soles were enrolled in the study. After taking consent a detailed history and clinical examination pertaining to the aim of the study was recorded and analysed, which included inspection of morphology and distribution of lesions and palpation of any swelling. Direct microscopic examination of scrapings, wet mounted with 10% potassium hydroxide was done for cases with scaly lesions. Those who had a pustule, gram staining was done. Patch testing using Indian Standard Battery Series was done for those cases of eczema. A sample for biopsy was taken when diagnosis could not be arrived clinically, and subjected to histopathological examination.
RESULTS: In our study of 300 patients with palmoplantar dermatoses, 164 were females and 136 were males, the ratio observed being 1.2:1. The peak incidence was found in the age group 21-30 years, with 41 females (25%) and 35 males (25.7%). Most frequently affected individuals in this study were housewives (30%). The most common five diseases of palmoplantar dermatoses were palmoplantar psoriasis (20.7%), moniliasis (19%), palmoplantar hyperhidrosis (7%), keratolysis exfoliativa (6%) and pitted keratolysis (6%). Majority of patients had involvement of both palms and soles (44.3%) as compared to patients with involvement of only palm (28%) and only sole (27.3%). The commonest palmoplantar dermatoses with only palm involvement was keratolysis exfoliativa (16.7%), with only sole involvement was moniliasis (41%) and with both palms and soles involvement was palmoplantar psoriasis (41.4%). Associated nail changes were seen in 80 cases (26.6%), with maximum incidence in palmoplantar psoriasis (62.5%). Associated dermatological conditions were observed in 43 patients (14.3%).
CONCLUSIONS: Palmoplantar dermatoses are frequently encount-ered in the dermatologic field. Further investigation with a wider and larger population is necessary to understand the epidemiology, based on which accurate diagnosis and proper treatment could be achieved.