A 7-year-old male, presented with pruritus skin lesions located on extremities. Lesions had appeared spontaneously 37 days before. The patient was treated for scabies but there was no improvement. His relatives had not present similar skin injuries and have pets or farm animals. Physical examination showed crops of sterile pustules associated with scaly and red skin located on both palms (predominating in left palm, Figure 1). Whole on the back of the hand exhibited itchy, well-demarcated oval red plaques with overlying silvery scale distributed symmetrically. In this case the plamoplantar pustulosis (PPP) was related with chronic plaque psoriasis. The patient was treated with topical steroid ointment; however, it is impossible to envisage when PPP lesions will reappear or if new lesions will be seen.

Figure 1: Physical examination of crops of sterile pustules associated with scaly and red skin.