Successful Management of Chronic Palmar Psoriasis with Endocrinal disturbances: A Case Report at Dr Batra’s

Abstract

Background

Palmoplantar psoriasis (PPP) is a chronic inflammatory variant of psoriasis affecting the palms and soles. It is characterized by erythema, hyperkeratosis, scaling, fissuring, pain, and functional disability that markedly impair quality of life. Nail involvement and metabolic comorbidities such as diabetes mellitus, obesity, hypertension, and thyroid dysfunction are frequently associated with chronic psoriasis. Despite topical corticosteroids, keratolytics, systemic immunomodulators, and biologic therapies, many patients experience recurrent exacerbations and incomplete remission. Individualized homoeopathy considers the constitutional characteristics of the patient in addition to the clinical diagnosis while selecting the similimum.

Case Presentation

A 44-year-old male presented with chronic palmoplantar psoriasis of 5–6 years' duration characterized by erythematous, hyperkeratotic plaques over both palms and soles with silvery-white scaling, painful fissures, and nail involvement affecting one toenail. The lesions progressively worsened since 2023 despite prolonged conventional treatment. Associated illnesses included hypothyroidism treated with Thyroxine 50 µg since 2015 and recently diagnosed Type 2 Diabetes Mellitus managed with metformin. Constitutional evaluation revealed a disciplined, analytical, emotionally controlled individual with a history of grief and marked change from an aggressive to a more calculating personality. Based on constitutional analysis, Natrum muriaticum was prescribed.

Outcome

Serial follow-up demonstrated progressive reduction in erythema, scaling, fissuring, and itching. By June–July 2026, palmar lesions had improved by approximately 80%, while plantar lesions also demonstrated marked improvement. Glycaemic control remained satisfactory (HbA1c 6.4%), thyroid profile remained stable, and lipid parameters were within acceptable limits.

Conclusion

This case demonstrates sustained improvement in chronic palmoplantar psoriasis associated with metabolic comorbidities following individualized constitutional homoeopathic treatment integrated with lifestyle modification.