Palmoplantar Psoriasis: A Review of Current Therapy

Miceli, Alyssa; Rogge, Megan; Czernik, Annette

doi:10.1177/247553031521a00106

Cited by 14 publications

(23 citation statements)

References 31 publications

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“…As in psoriasis vulgaris, palmoplantar plaque psoriasis has also been found to be significantly associated with a number of comorbidities such as diabetes mellitus, cardiovascular disease, and mood disorders [10]. Current practices usually employ superpotent topical steroids as first-line topical therapies and acitretin as first-line systemic therapy [11]. Second-line therapies include phototherapy and systemic agents such as methotrexate and cyclosporine [11].…”

Section: Discussionmentioning

confidence: 99%

“…Current practices usually employ superpotent topical steroids as first-line topical therapies and acitretin as first-line systemic therapy [11]. Second-line therapies include phototherapy and systemic agents such as methotrexate and cyclosporine [11]. Biologic therapies are typically employed in patients who have failed/cannot tolerate topical therapies and other systemic therapies [11].…”

Section: Discussionmentioning

confidence: 99%

“…Second-line therapies include phototherapy and systemic agents such as methotrexate and cyclosporine [11]. Biologic therapies are typically employed in patients who have failed/cannot tolerate topical therapies and other systemic therapies [11]. Though palmoplantar psoriasis is often resistant to treatment, biologic therapies such as risankizumab may offer promising results.…”

Section: Discussionmentioning

confidence: 99%

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Palmoplantar Psoriasis Successfully Treated With Risankizumab

Alajlan¹,

Qadoumi²

2021

Cureus

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Palmoplantar psoriasis is a variant of psoriasis that affects the palms and soles. Despite the small body surface area affected, palmoplantar psoriasis can have significant implications on a patient’s mental health, justifying the urgency in treating this condition. Palmoplantar psoriasis is also known to be challenging to treat. In this case report, we present a male who presented with a 15-year history of psoriasis with significant palmoplantar involvement, managed with topical and systemic therapies, achieving a minimal response. After trying other therapies including acitretin and adalimumab, we eventually started the patient on risankizumab, an anti-IL-23 antibody. Following the fourth dose of risankizumab, the patient’s palmoplantar lesions completely resolved. We further discuss why risankizumab may be considered a treatment option in resistant palmoplantar psoriasis cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Palmoplantar Psoriasis Successfully Treated With Risankizumab

Alajlan¹,

Qadoumi²

2021

Cureus

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“…This is mostly due to the absence of robust data on the treatment of this disease form, as patients affected by PP are usually excluded from clinical trials, having less than 10% of their BSA involved. 3 Clinical severity scores routinely used for the assessment of PP include PPPGA (Palmo Plantar Psoriasis Global Assessment) and PPPASI (modified Palmo Plantar Psoriasis Area and Severity Index).…”

Section: Introductionmentioning

confidence: 99%

Apremilast for the treatment of palmo‐plantar non‐pustular psoriasis: A real‐life single‐center retrospective study

Pavia

Gargiulo

Cortese

et al. 2021

Dermatologic Therapy

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Palmoplantar psoriasis (PP) is a type of psoriasis that involves the skin of the palms and soles and can present as hyperkeratotic, similar to the vulgaris psoriasis of the body. Apremilast, as an oral inhibitor of phosphodiesterase 4 (PDE4), is currently approved for the treatment of psoriatic arthritis and for moderate‐to‐severe psoriasis in adult patients who have not responded or have contraindications or do not tolerate other systemic treatments. We evaluated the efficacy and safety of apremilast in the treatment of non‐pustular palmo‐plantar psoriasis in a cohort of 12 patients. We found a clinical response of clear/almost clear palmoplantar psoriasis (PPPGA score 0/1) in 83.33% of our patients, at week 16. No significant safety issues were reported and none of our patients had to discontinue the drug.

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“…It can present with various morphologies ranging from sharply demarcated hyperkeratotic plaques to predominantly pustular lesions, or a combination of the two. Though affecting a small percentage of a patient's body surface area, palmoplantar psoriasis can cause significant discomfort and physical disability, particularly when painful deep fissuring or bleeding occurs [4] . Methotrexate is a time-tested drug commonly used in all clinical types of psoriasis.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of transdermal methotrexate iontophoresis and low dose oral methotrexate in the treatment of palmoplantar psoriasis

Raja¹,

Pk²,

B³

et al. 2021

Int. J. Dermatol. Venereology Leprosy Sci.

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Background: Psoriasis exclusively involving the palms and soles is known as palmoplantar psoriasis. Though it involves a small body surface area, poses significant morbidity in daily activities of patients. Systemic treatments are indicated for extensive and refractory cases. Systemic toxicity limits the usage of systemic drugs. Methotrexate a time proven drug for psoriasis has been used in oral, injectables and topical formulation. Iontophoresis is a transdermal drug delivery system which can enhance the penetration of methotrexate drug locally, minimizing the systemic side effects. Aim: To evaluate the efficacy of transdermal delivery of methotrexate through iontophoresis in comparison to oral methotrexate in palmoplantar psoriasis. Methods: Forty patients attending the psoriasis clinic with psoriasis involving palms and/or soles are randomly allocated into two groups (20 in each). Methotrexate iontophoresis group was treated with iontophoresis weekly once for 16 weeks whereas oral methotrexate group was given 0.2-0.4mg/kg/week every weekly for 16 weeks. The severity of palmoplantar psoriasis was assessed by mPPPASI at baseline, 4,8,12 and 16 weeks. Results: Males are higher in both study groups. The most common age group of onset was at 40-60 years. Palms and soles was involved in 55%, soles only in 27.5% and palms alone in 17.5%. Mean mPPPASI reduction was gradual in both groups with comparable efficacy. mPPPASI reduction at 16 weeks was higher in Oral methotrexate with good compliance. Conclusion: Methotrexate delivered by Iontophoresis was equally effective as Oral methotrexate in treatment of palmoplantar psoriasis.

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Palmoplantar Psoriasis: A Review of Current Therapy

Cited by 14 publications

References 31 publications

Palmoplantar Psoriasis Successfully Treated With Risankizumab

Palmoplantar Psoriasis Successfully Treated With Risankizumab

Apremilast for the treatment of palmo‐plantar non‐pustular psoriasis: A real‐life single‐center retrospective study

Efficacy of transdermal methotrexate iontophoresis and low dose oral methotrexate in the treatment of palmoplantar psoriasis

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