36 year old male with longstanding rash on palms and soles

    36 year old male presents with rash on his palms and soles since the 7th grade. He has tried topical therapy including steroid creams and moisturizers with some control, but no major improvement. Recently has developed nonhealing ulcer with foul smell over left sole after using pumice stone. Also complains of recurrent "red bumps" over his bilateral lower extremities that can be large, and have been previously treated with incision & drainage, and antibiotic therapy. He has no personal history or family history of psoriasis. No joint pain. No other rashes in other areas of the body, no other skin concerns.