pustulosis palmaris et plantaris pustulosis palmaris et plantaris pustulosis palmaris et plantaris is a chronic recurrent pustular dermatosis (that is, a pustulosis or pustular psoriasis) localized on the palms and soles only, characterized histologically by intraepidermal pustules filled with neutrophils.: 411, 628 : 204 it can occur as part of the sapho syndrome. pustulosis palmaris et plantarisother namespustulosis of palms and soles, palmoplantar pustulosis, persistent palmoplantar pustulosis, pustular psoriasis of the barber type, and pustular psoriasis of the extremitiespustulosis palmaris et plantarisspecialtydermatology differential diagnosissapho syndrome treatment systematic reviews show evidence to support the use of systemic retinoids alone and in combination with photochemotherapy to improve symptoms of chronic palmoplantar pustulosis, with a combination more effective than one alone. there is also evidence to support topical steroids under hydrocolloid occlusion dressings, low dose ciclosporin, tetracyclines, and grenz-ray therapy. there is no evidence to support the use of hydroxyurea in chronic palmoplantar pustulosis. treatment with guselkumab, an anti–interleukin 23 monoclonal antibody has shown a decrease in the size of the area affected and severity.