Palmoplantar Pustular Psoriasis Induced by Adalimumab: A Case Report and Literature Review

Abstract

TNF-α inhibitors (anti-TNF-α) are agents increasingly used in the treatment of rheumatic diseases resistant to classical disease-modifying treatment and they provide significant improvement of disease activity. However, these agents have many cutaneous side effects including psoriasis. Numerous reports of the induction or worsening of psoriasis in patients treated with TNF antagonists indicate that this is not a rare phenomenon. In this study, we present a patient with ankylosing spondylitis who developed palmoplantar pustular psoriasis after receiving anti-TNF-α therapy for 4 months.

What do we know about palmoplantar pustulosis?

“…It is also significant that patients with psoriasis may develop PSV and pustular psoriatic lesions at different stages of the disease. Moreover, PSV and PPP lesions are the most common cutaneous adverse effects of biological treatment, mainly with anti‐TNF‐α drugs . This may be another argument to consider that these two conditions have a common pathogenic background.…”

Teriflunomide-Induced Palmoplantar Pustular Psoriasis: Case Report and Review of the Literature

“…Although there are some case reports of adalimumab-induced palmoplantar psoriasis in patients with ankylosing spondylitis [8], adalimumab was not blamed as a causative agent in this patient since she stopped using adalimumab long before switching to teriflunomide therapy. The patient's eruptions regressed after seven months of cessation and elimination of teriflunomide.…”

Biologics as a novel treatment option for palmoplantar pustulosis: a comprehensive review

“…A multicentre, retrospective study demonstrated that 50% of 50 PPP patients treated with adalimumab experienced improvements in disease severity, and 17.6% achieved complete lesion clearance (CC) [ 51 ]. Case reports also suggest adalimumab’s effectiveness in treating PPP [ 88 , 89 ], although it can sometimes induce PPP [ 90 , 91 ].…”