Treatment of Chronic Rash in Antecubital and Palmar Areas

Diagnostic Considerations

• Inverse psoriasis can affect flexural surfaces including antecubital fossae, presenting as erythematous plaques with minimal scale, and palmoplantar pustular psoriasis involves palms with pustules on an erythematous background, according to the American Academy of Dermatology 1

First-Line Treatment Algorithm

• Urea-containing moisturizers (5%-10%) are particularly effective for skin barrier restoration, as recommended by the American Academy of Dermatology, with a strength of evidence supported by multiple studies 2, 3, 4, 5, 6, 7, 8

Critical Management Pitfalls to Avoid

• Avoid trigger factors such as frequent washing with hot water, skin irritants, and excessive sun exposure, and apply sunscreen SPF 15 to exposed areas every 2 hours when outside, as suggested by the American Academy of Dermatology 5, 7, 8