Pustular eruption on the palms and soles associated with zinc allergy and perspiration.

Persistent pustular eruption localized to the palms and soles may occur in relation to palmoplantar pustulosis, smoking, bacterial infections, metal allergy, and tumor necrosis factor-alfa inhibitors.1,2 It presents with crops of sterile pustules on an erythemato-squamous background, sometimes accompanied by nonpalmoplantar skin lesions or peripheral/axial arthritis.1 In certain cases, bacterial infections, including tonsillitis and dental infections, and dental metal allergy to nickel, mercury, and gold may be involved in the pathogenesis of pustular formation.