Lesion Pattern of Psoriasis of the Feet

Footwear for Psoriasis and Psoriatic Arthritis: A Systematic Review

“…The second case report described the experience of a 46-year-old female with psoriasis who developed psoriatic lesions consistent with a weightbearing (Koebner-based) distribution on the plantar aspects of the feet after beginning to play tennis [14]. Her exercise-based symptom exacerbation was then resolved through use of an orthotic which minimized vertical and shear forces during ambulation [14].…”

“…Psoriasis and PsA impact foot-related pain and disability in different ways. The classic psoriatic rash, which involves erythematous and well-demarcated scaling plaques, is commonly found on the plantar surface of the foot [11,12,14,17]. This may in part relate to the Koebner phenomenon, in which psoriatic lesions are worse in areas subjected to pressure or friction [11,12].…”

“…This may in part relate to the Koebner phenomenon, in which psoriatic lesions are worse in areas subjected to pressure or friction [11,12]. These findings are usually bilateral, and are most common in the heel region, the lateral borders of the feet, and the metatarsals [14]. The Koebner phenomenon underscores the importance of appropriate footwear and textiles in the approach to psoriasis management [11,12].…”

“…Corn, et al [14] Case Study A 46-year-old female patient with pre-existing psoriasis, who developed psoriatic lesions on the plantar surfaces of her feet after beginning to play tennis. It was concluded that these lesions followed the normal weightbearing distribution of the foot.…”

“…Specific footwear and orthotic interventions were also analyzed by articles included in this review. It was found that the use of a simple orthotic designed to minimize the vertical and shear forces during ambulation led to successful resolution of psoriatic foot lesions [14]. Specific features of orthoses that should be considered include a heel lift to address achilles tendinopathy/enthesopathy (a common feature of PsA), a strong medial arch support to stabilize the subtalar joint, a cushioned top layer, and a metatarsal bar to offer protection to the first MTP joint, and to minimize PsA-related pain [13,16].…”