Psoriasis of the palms may be difficult to discern from hand eczema. The silvery, dense, scaling plaques are also seen in chronic hand eczema.

This same presentation of defined round scaling plaques of the dorsum is seen in nummular eczema.

Pustular psoriasis of the palms and soles. Lesions are localized or may involve the entire palms or soles.

Pustular psoriasis lesions resemble dyshidrotic eczema. Pustules evolve to deep-set brown spots and then into scaling papules.