How to control pustular psoriasis

I have pustular psoriasis on my palms and soles.  My feet especially are really bad.  I have been on Taclonex which hasn't helped in the least.  I get no remissions, and it's always there.  Is there any correlation with Celiac Disease?  I never had any problems prior to the diagnosis.  It's really bad, and I usually have pustules on my feet at all times.  My feet peel on an average of once weekly.  It's really frustrating, and the only break I ever get is about 1 week if I have a Kenalog injection, which I don't like to take.  It's really wearing on me.  What can I do?  I don't feel my dermatologist is doing much for me.  Any help would be appreciated.  Should I go to a dermatologist who specializes in psoriasis?  I live in the Nashville area.

[Bhupinder Kaur, MD]

Hello,
Pustular psoriasis is an uncommon form of psoriasis. It is of three types: acute, subacute and chronic. Treatment consists of topical treatment  like corticosteroids, vitamin D-3 derivatives, coal tar, anthralin, or retinoids; PUVA+psoralen ( phototherapy) and systemic treatment like retinoids. You can discuss these treatment options with your dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.