An Unusual Presentation of Plantar Psoriasis: A Case Report

Plantar psoriasis is a chronic inflammatory skin disorder, typically characterized by erythematous plaques with thick silvery scales localized on the soles. This condition can significantly impair patients' quality of life, particularly through pain and mobility challenges. It is considered a subtype of plaque psoriasis but presents unique diagnostic and therapeutic challenges due to its specific location. We report the case of a 44-year-old female with bilateral burning and scaling of the feet, initially misdiagnosed and treated for fungal infections without success. Despite persistent symptoms, a dermatological consultation was delayed for three years. Upon reassessment, she presented with scaly lesions on the elbows and feet. Treatment with topical betamethasone and calcipotriol led to partial resolution of plantar lesions but not the elbow lesions. Following a comprehensive evaluation, the patient was diagnosed with plantar psoriasis and maintained on topical therapy, avoiding systemic treatments. Her management highlights the importance of accurate diagnosis and timely specialist referral. This case illustrates the challenges in diagnosing plantar psoriasis, particularly when overlapping with other dermatological conditions. A conservative treatment approach with topical steroids proved effective in managing symptoms. The patient's delayed referral underscores the need for prompt specialist care to mitigate prolonged discomfort. Additionally, comorbidities like anxiety and depression may exacerbate the patient's symptoms, emphasizing the importance of integrated care that addresses both physical and psychological aspects. This case emphasizes the necessity of timely and accurate diagnosis, early referral for specialist care, and a multidisciplinary management approach for chronic dermatological conditions such as plantar psoriasis. Further research is warranted to explore the interplay between psychological factors and dermatological conditions to improve patient outcomes.