Dermoscopy and UVFD in Differentiating Palmoplantar Psoriasis and Palmoplantar Eczema

Palmoplantar psoriasis and palmoplantar eczema are chronic inflammatory skin diseases that may show similar findings on the palms and soles, such as redness, scaling, thickening of the skin, fissures, itching, and burning. Because these conditions can look alike, distinguishing between them in routine clinical practice may be difficult. This prospective, single-center observational study was designed to compare polarized dermoscopic and ultraviolet-induced fluorescence dermoscopic (UVFD) findings in adult patients with palmoplantar psoriasis and palmoplantar eczema. A total of 81 patients aged 18 years and older were included: 41 patients with clinically and/or histopathologically confirmed palmoplantar plaque psoriasis and 40 patients with palmoplantar eczema. Dermoscopic and UVFD images were evaluated to identify vascular, scaling, surface, and fluorescence-related features that may help differentiate palmoplantar psoriasis from palmoplantar eczema. The study aims to assess whether these non-invasive imaging methods can provide additional diagnostic clues to support clinical evaluation.

Inclusion Criteria: * Age 18 years or older. * Clinical diagnosis of palmoplantar psoriasis or palmoplantar eczema involving the palms and/or soles. * For the palmoplantar psoriasis group: presence of sharply demarcated erythematous and scaly plaques on the palms and/or soles, with diagnosis confirmed clinically and/or histopathologically. * In clinically uncertain palmoplantar psoriasis cases, at least one supporting feature such as psoriatic lesions outside the palmoplantar area, psoriatic nail involvement, psoriatic arthritis, personal history of psoriasis, or family history of psoriasis. * For the palmoplantar eczema group: presence of chronic or recurrent palmoplantar eczema with hyperkeratotic and/or fissured palmoplantar plaques, with diagnosis confirmed clinically and/or histopathologically. * Ability and willingness to provide written informed consent. Exclusion Criteria: * Age younger than 18 years. * Presence of another palmoplantar dermatosis that may interfere with the diagnosis of palmoplantar psoriasis or palmoplantar eczema. * Histopathological findings inconsistent with the clinical diagnosis, when histopathological examination was performed.