Palmoplantar Psoriasis Treatment with Ustekinumab

Introduction:

• Palmoplantar psoriasis presents as sterile pustules with hyperkeratosis, erythema, scaling and fissuring on the palms and soles
• Treatment is challenging. topicals don’t really work and acitretin is not always effective.

Methodology:

• prospective study
• 9 patients, mean age 48 years old
• ustekinumab administered subcutaneously at weeks 0,4 and then every 12 weeks
• evaluation with PPPASI (Palmo-Pustular PASI), PASI and DLQI

Results:

• complete response in 2 patients after 24 weeks
• PPPASI 75 in 4 patients
• on average PPPASI was reduced by 56.5% and there were no treatment failures

Comment: although no severe reactions were noted, it would be useful to conduct a larger study to measure this as well as validate further the results.

Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

Source of information: p336 Successful treatment of palmoplantar pustular psoriasis with ustekinumab. Buder V et al. EADV Annual Meeting (2014), Amsterdam The Netherlands