Palmoplantar Psoriasis and Palmoplantar Pustulosis: Current Treatment and Future Prospects


Palmoplantar psoriasis and palmoplantar pustulosis are chronic skin diseases with a large impact on patient quality of life. They are frequently refractory to treatment, being generally described as a therapeutic challenge. This article aims to review the definitions of palmoplantar psoriasis and palmoplantar pustulosis, highlighting the similarities and differences in terms of epidemiology, clinical presentation, genetics, histopathology, and pathogenesis, as well as treatment options for both entities. Classical management of mild to moderate palmoplantar pustulosis and palmoplantar psoriasis relies on use of potent topical corticosteroids, phototherapy, and/or acitretin. Nevertheless, these drugs have proven to be insufficient in long-term control of extensive disease. Biologic therapy—namely, anti-interleukin-17 agents and phosphodiesterase type 4 inhibitors—has recently shown promising results in the treatment of palmoplantar psoriasis. Knowledge of the pathophysiologic pathways of both entities is of utmost importance and may, in the future, allow development of molecularly targeted therapeutics.

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  1. 1.

    Brunasso AM, Puntoni M, Aberer W, Delfino C, Fancelli L, Massone C. Clinical and epidemiological comparison of patients affected by palmoplantar plaque psoriasis and palmoplantar pustulosis: a case series study. Br J Dermatol. 2013;168:1243–51. doi:10.1111/bjd.12223.

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Gudjonsson JE, Elder JT. Psoriasis: epidemiology. Clin Dermatol. 2007;25:535–46. doi:10.1016/j.clindermatol.2007.08.007.

    Article  PubMed  Google Scholar 

  3. 3.

    Naldi L, Gambini D. The clinical spectrum of psoriasis. Clin Dermatol. 2007;25:510–8. doi:10.1016/j.clindermatol.2007.08.003.

    Article  PubMed  Google Scholar 

  4. 4.

    Pettey AA, Balkrishnan R, Rapp SR, Fleischer AB, Feldman SR. Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice. J Am Acad Dermatol. 2003;49:271–5.

    Article  PubMed  Google Scholar 

  5. 5.

    Farley E, Masrour S, McKey J, Menter A. Palmoplantar psoriasis: a phenotypical and clinical review with introduction of a new quality-of-life assessment tool. J Am Acad Dermatol. 2009;60:1024–31. doi:10.1016/j.jaad.2008.11.910.

    Article  PubMed  Google Scholar 

  6. 6.

    Griffiths CE, Christophers E, Barker JN, Chalmers RJ, Chimenti S, Krueger GG, et al. A classification of psoriasis vulgaris according to phenotype. Br J Dermatol. 2007;156:258–62. doi:10.1111/j.1365-2133.2006.07675.x.

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Yamamoto T. Extra-palmoplantar lesions associated with palmoplantar pustulosis. J Eur Acad Dermatol. 2009;23:1227–32. doi:10.1111/j.1468-3083.2009.03296.x.

    CAS  Article  Google Scholar 

  8. 8.

    Barber HW. Acrodermatitis continua vel perstans (dermatitis repens) and psoriasis pustulosa. Br J Dermatol. 1930;42:500–18.

    Article  Google Scholar 

  9. 9.

    Ammoury A, El Sayed F, Dhaybi R, Bazex J. Palmoplantar pustulosis should not be considered as a variant of psoriasis. J Eur Acad Dermatol. 2008;22:392–3. doi:10.1111/j.1468-3083.2007.02344.x.

    CAS  Article  Google Scholar 

  10. 10.

    Chung J, Callis Duffin K, Takeshita J, Shin DB, Krueger GG, Robertson AD, et al. Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis. J Am Acad Dermatol. 2014;71:623–32. doi:10.1016/j.jaad.2014.04.063.

    Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Fries JF. Toward an understanding of patient outcome measurement. Arthritis Rheum. 1983;26:697–704.

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Gimenez-Garcia R, Sanchez-Ramon S, Cuellar-Olmedo LA. Palmoplantar pustulosis: a clinicoepidemiological study. The relationship between tobacco use and thyroid function. J Eur Acad Dermatol. 2003;17:276–9.

    CAS  Article  Google Scholar 

  13. 13.

    Hagforsen E, Awder M, Lefvert AK, Nordlind K, Michaelsson G. Palmoplantar pustulosis: an autoimmune disease precipitated by smoking? Acta Derm Venereol. 2002;82:341–6.

    Article  PubMed  Google Scholar 

  14. 14.

    Rosen K, Lindstedt G, Mobacken H, Nystrom E. Thyroid function in patients with pustulosis palmoplantaris. J Am Acad Dermatol. 1988;19:1009–16.

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Al-Mutairi N, Abdalla TO, Nour TM. Resistant palmoplantar lesions in patients of psoriasis: evaluation of the causes and comparison of the frequency of delayed-type hypersensitivity in patients without palm and sole lesions. Med Princ Pract. 2014;23:561–7. doi:10.1159/000365573.

    Article  PubMed  Google Scholar 

  16. 16.

    Izaki S, Goto Y, Kaburagi Y, Kitamura K, Nomaguchi H. Antibody production to heat shock proteins with Mr 65 kD (HSP65) in cutaneous inflammation: a possible relation to focal infection. Acta Otolaryngol Suppl. 1996;523:197–200.

    CAS  PubMed  Google Scholar 

  17. 17.

    Hagforsen E, Hedstrand H, Nyberg F, Michaelsson G. Novel findings of Langerhans cells and interleukin-17 expression in relation to the acrosyringium and pustule in palmoplantar pustulosis. Br J Dermatol. 2010;163:572–9. doi:10.1111/j.1365-2133.2010.09819.x.

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Hill VA, Ostlere LS. Psoriasis of the hands kobnerizing in contact dermatitis. Contact Dermatitis. 1998;39:194.

    CAS  Article  PubMed  Google Scholar 

  19. 19.

    Aydin O, Engin B, Oguz O, Ilvan S, Demirkesen C. Non-pustular palmoplantar psoriasis: is histologic differentiation from eczematous dermatitis possible? J Cutan Pathol. 2008;35:169–73.

    PubMed  Google Scholar 

  20. 20.

    O’Rielly DD, Rahman P. Pharmacogenetics of psoriasis. Pharmacogenomics. 2011;12:87–101. doi:10.2217/pgs.10.166.

    Article  PubMed  Google Scholar 

  21. 21.

    Nair RP, Stuart PE, Nistor I, Hiremagalore R, Chia NV, Jenisch S, et al. Sequence and haplotype analysis supports HLA-C as the psoriasis susceptibility 1 gene. Am J Hum Genet. 2006;78:827–51. doi:10.1086/503821.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Talamonti M, Botti E, Galluzzo M, Teoli M, Spallone G, Bavetta M, et al. Pharmacogenetics of psoriasis: HLA-Cw6 but not LCE3B/3C deletion nor TNFAIP3 polymorphism predisposes to clinical response to interleukin 12/23 blocker ustekinumab. Br J Dermatol. 2013;169:458–63. doi:10.1111/bjd.12331.

    CAS  Article  PubMed  Google Scholar 

  23. 23.

    Mossner R, Frambach Y, Wilsmann-Theis D, Lohr S, Jacobi A, Weyergraf A, et al. Palmoplantar pustular psoriasis is associated with missense variants in CARD14, but not with loss-of-function mutations in IL36RN in European patients. J Invest Dermatol. 2015;135:2538–41. doi:10.1038/jid.2015.186.

    Article  PubMed  Google Scholar 

  24. 24.

    Asumalahti K, Ameen M, Suomela S, Hagforsen E, Michaelsson G, Evans J, et al. Genetic analysis of PSORS1 distinguishes guttate psoriasis and palmoplantar pustulosis. J Invest Dermatol. 2003;120:627–32. doi:10.1046/j.1523-1747.2003.12094.x.

    CAS  Article  PubMed  Google Scholar 

  25. 25.

    Kingo K, Mossner R, Koks S, Ratsep R, Kruger U, Vasar E, et al. Association analysis of IL19, IL20 and IL24 genes in palmoplantar pustulosis. Br J Dermatol. 2007;156:646–52. doi:10.1111/j.1365-2133.2006.07731.x.

    CAS  Article  PubMed  Google Scholar 

  26. 26.

    Prieto-Perez R, Cabaleiro T, Dauden E, Ochoa D, Roman M, Abad-Santos F. Genetics of psoriasis and pharmacogenetics of biological drugs. Autoimmune Dis. 2013;2013:613086. doi:10.1155/2013/613086.

    PubMed  PubMed Central  Google Scholar 

  27. 27.

    Lee E, Zarei M, LaSenna C, Villada G, Romanelli P. Psoriasis targeted therapy: characterization of interleukin 17A expression in subtypes of psoriasis. J Drugs Dermatol. 2015;14:1133–6.

    CAS  PubMed  Google Scholar 

  28. 28.

    Murakami M, Ohtake T, Horibe Y, Ishida-Yamamoto A, Morhenn VB, Gallo RL, et al. Acrosyringium is the main site of the vesicle/pustule formation in palmoplantar pustulosis. J Invest Dermatol. 2010;130:2010–6. doi:10.1038/jid.2010.87.

    CAS  Article  PubMed  Google Scholar 

  29. 29.

    Yamamoto T, Katayama I, Nishioka K. Restricted usage of the T-cell receptor V beta repertoire in tonsillitis in association with palmoplantar pustulosis. Acta Derm Venereol. 1998;78:161–3.

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    Nozawa H, Kishibe K, Takahara M, Harabuchi Y. Expression of cutaneous lymphocyte-associated antigen (CLA) in tonsillar T-cells and its induction by in vitro stimulation with alpha-streptococci in patients with pustulosis palmaris et plantaris (PPP). Clin Immunol. 2005;116:42–53. doi:10.1016/j.clim.2005.01.009.

    CAS  Article  PubMed  Google Scholar 

  31. 31.

    Bacharach-Buhles M, el Gammal S, Altmeyer P. The pustular bacterid (Andrews). Are there clinical criteria for differentiating from psoriasis pustulosa palmaris et plantaris? [in German]. Hautarzt. 1993;44:221–4.

    CAS  PubMed  Google Scholar 

  32. 32.

    Iraji F, Abtahi-Naeini B, Heydari H, Pourazizi M. Pustular bacterid: look at the throat for prevention over treatment. Int J Prev Med. 2015;6:51. doi:10.4103/2008-7802.158180.

    Article  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Wu W, Debbaneh M, Moslehi H, Koo J, Liao W. Tonsillectomy as a treatment for psoriasis: a review. J Dermatol Treat. 2014;25:482–6. doi:10.3109/09546634.2013.848258.

    Article  Google Scholar 

  34. 34.

    Hagforsen E, Edvinsson M, Nordlind K, Michaelsson G. Expression of nicotinic receptors in the skin of patients with palmoplantar pustulosis. Br J Dermatol. 2002;146:383–91.

    CAS  Article  PubMed  Google Scholar 

  35. 35.

    Michaelsson G, Gustafsson K, Hagforsen E. The psoriasis variant palmoplantar pustulosis can be improved after cessation of smoking. J Am Acad Dermatol. 2006;54:737–8. doi:10.1016/j.jaad.2005.07.024.

    Article  PubMed  Google Scholar 

  36. 36.

    Bissonnette R, Nigen S, Langley RG, Lynde CW, Tan J, Fuentes-Duculan J, et al. Increased expression of IL-17A and limited involvement of IL-23 in patients with palmo-plantar (PP) pustular psoriasis or PP pustulosis; results from a randomised controlled trial. J Eur Acad Dermatol. 2014;28:1298–305. doi:10.1111/jdv.12272.

    CAS  Article  Google Scholar 

  37. 37.

    Murakami M, Hagforsen E, Morhenn V, Ishida-Yamamoto A, Iizuka H. Patients with palmoplantar pustulosis have increased IL-17 and IL-22 levels both in the lesion and serum. Exp Dermatol. 2011;20:845–7. doi:10.1111/j.1600-0625.2011.01325.x.

    CAS  Article  PubMed  Google Scholar 

  38. 38.

    Adisen E, Tekin O, Gulekon A, Gurer MA. A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients. J Eur Acad Dermatol. 2009;23:814–9. doi:10.1111/j.1468-3083.2009.03197.x.

    CAS  Article  Google Scholar 

  39. 39.

    Marsland AM, Chalmers RJ, Hollis S, Leonardi-Bee J, Griffiths CE. Interventions for chronic palmoplantar pustulosis. Cochrane Database Syst Rev. 2006;(1):CD001433. doi:10.1002/14651858.CD001433.pub2.

  40. 40.

    Sevrain M, Richard MA, Barnetche T, Rouzaud M, Villani AP, Paul C, et al. Treatment for palmoplantar pustular psoriasis: systematic literature review, evidence-based recommendations and expert opinion. J Eur Acad Dermatol. 2014;28:13–6. doi:10.1111/jdv.12561.

    CAS  Article  Google Scholar 

  41. 41.

    Carrascosa JM, Plana A, Ferrandiz C. Effectiveness and safety of psoralen-UVA (PUVA) topical therapy in palmoplantar psoriasis: a report on 48 patients. Actas Dermosifiliogr. 2013;104:418–25. doi:10.1016/j.adengl.2013.04.005.

    CAS  Article  PubMed  Google Scholar 

  42. 42.

    Bissonnette R, Poulin Y, Guenther L, Lynde CW, Bolduc C, Nigen S. Treatment of palmoplantar psoriasis with infliximab: a randomized, double-blind placebo-controlled study. J Eur Acad Dermatol. 2011;25:1402–8. doi:10.1111/j.1468-3083.2011.03984.x.

    CAS  Article  Google Scholar 

  43. 43.

    Lozinski A, Barzilai A, Pavlotsky F. Broad-band UVB versus paint PUVA for palmoplantar psoriasis treatment. J Dermatol Treat. 2016;27(3):221–3. doi:10.3109/09546634.2015.1093588.

    CAS  Article  Google Scholar 

  44. 44.

    Riad K, Felix P, Dorit S, Gregory K, Nadim K, Henri T. The use of topical PUVA for palmoplantar dermatoses. J Dermatol Treat. 2006;17:304–7. doi:10.1080/09546630600866442.

    Article  Google Scholar 

  45. 45.

    Nistico SP, Saraceno R, Chiricozzi A, Giunta A, Di Stefani A, Zerbinati N. UVA-1 laser in the treatment of palmoplantar pustular psoriasis. Photomed Laser Surg. 2013;31:434–8. doi:10.1089/pho.2013.3545.

    Article  PubMed  Google Scholar 

  46. 46.

    Sezer E, Erbil AH, Kurumlu Z, Tastan HB, Etikan I. Comparison of the efficacy of local narrowband ultraviolet B (NB-UVB) phototherapy versus psoralen plus ultraviolet A (PUVA) paint for palmoplantar psoriasis. J Dermatol. 2007;34:435–40. doi:10.1111/j.1346-8138.2007.00306.x.

    CAS  Article  PubMed  Google Scholar 

  47. 47.

    Furuhashi T, Torii K, Kato H, Nishida E, Saito C, Morita A. Efficacy of excimer light therapy (308 nm) for palmoplantar pustulosis with the induction of circulating regulatory T cells. Exp Dermatol. 2011;20:768–70. doi:10.1111/j.1600-0625.2011.01316.x.

    CAS  Article  PubMed  Google Scholar 

  48. 48.

    Matsunami E, Takashima A, Mizuno N, Jinno T, Ito H. Topical PUVA, etretinate, and combined PUVA and etretinate for palmoplantar pustulosis: comparison of therapeutic efficacy and the influences of tonsillar and dental focal infections. J Dermatol. 1990;17:92–6.

    CAS  Article  PubMed  Google Scholar 

  49. 49.

    Ettler K, Richards B. Acitretin therapy for palmoplantar pustulosis combined with UVA and topical 8-MOP. Int J Dermatol. 2001;40:541–2.

    CAS  Article  PubMed  Google Scholar 

  50. 50.

    Lassus A, Geiger JM. Acitretin and etretinate in the treatment of palmoplantar pustulosis: a double-blind comparative trial. Br J Dermatol. 1988;119:755–9.

    CAS  Article  PubMed  Google Scholar 

  51. 51.

    Mrowietz U, van de Kerkhof PC. Management of palmoplantar pustulosis: do we need to change? Br J Dermatol. 2011;164:942–6. doi:10.1111/j.1365-2133.2011.10233.x.

    CAS  Article  PubMed  Google Scholar 

  52. 52.

    Raguideau F, Mezzarobba M, Zureik M, Weill A, Ricordeau P, Alla F. Compliance with pregnancy prevention plan recommendations in 8672 French women of childbearing potential exposed to acitretin. Pharmacoepidemiol Drug Saf. 2015;24:526–33. doi:10.1002/pds.3763.

    CAS  Article  PubMed  Google Scholar 

  53. 53.

    Irla N, Navarini AA, Yawalkar N. Alitretinoin abrogates innate inflammation in palmoplantar pustular psoriasis. Br J Dermatol. 2012;167:1170–4. doi:10.1111/j.1365-2133.2012.11063.x.

    CAS  Article  PubMed  Google Scholar 

  54. 54.

    Wald JM, Klufas DM, Strober BE. The use of methotrexate, alone or in combination with other therapies, for the treatment of palmoplantar psoriasis. J Drugs Dermatol. 2015;14:888–92.

    CAS  PubMed  Google Scholar 

  55. 55.

    Gupta SK, Singh KK, Lalit M. Comparative therapeutic evaluation of different topicals and narrow band ultraviolet B therapy combined with systemic methotrexate in the treatment of palmoplantar psoriasis. Indian J Dermatol. 2011;56:165–70. doi:10.4103/0019-5154.80410.

    PubMed  PubMed Central  Google Scholar 

  56. 56.

    Janagond AB, Kanwar AJ, Handa S. Efficacy and safety of systemic methotrexate vs. acitretin in psoriasis patients with significant palmoplantar involvement: a prospective, randomized study. J Eur Acad Dermatol. 2013;27:e384–9. doi:10.1111/jdv.12004.

  57. 57.

    Berth-Jones J. The use of ciclosporin in psoriasis. J Dermatol Treat. 2005;16:258–77. doi:10.1080/09546630500423914.

    CAS  Article  Google Scholar 

  58. 58.

    Gotestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. 2016;75(5):795–810. doi:10.1136/annrheumdis-2015-208840.

  59. 59.

    Ryan C, Menter A, Warren RB. The latest advances in pharmacogenetics and pharmacogenomics in the treatment of psoriasis. Mol Diagn Ther. 2010;14:81–93. doi:10.2165/11534550-000000000-00000.

    CAS  Article  PubMed  Google Scholar 

  60. 60.

    Perez-Alvarez R, Diaz-Lagares C, Garcia-Hernandez F, Lopez-Roses L, Brito-Zeron P, Perez-de-Lis M, et al. Hepatitis B virus (HBV) reactivation in patients receiving tumor necrosis factor (TNF)-targeted therapy: analysis of 257 cases. Medicine (Baltimore). 2011;90:359–71. doi:10.1097/MD.0b013e3182380a76.

    CAS  Article  PubMed  Google Scholar 

  61. 61.

    Brunasso AM, Salvini C, Massone C. Efalizumab for severe palmo-plantar psoriasis: an open-label pilot trial in five patients. J Eur Acad Dermatol. 2009;23:415–9. doi:10.1111/j.1468-3083.2008.03062.x.

    CAS  Article  Google Scholar 

  62. 62.

    Stinco G, Piccirillo F, Patrone P. Treatment of palmoplantar pustular psoriasis with efalizumab: a quick response with early recurrence. Eur J Dermatol. 2008;18:91–2. doi:10.1684/ejd.2007.0326.

    PubMed  Google Scholar 

  63. 63.

    Wozel G, Vitez L, Meurer M. Palmoplantar pustular psoriasis: successful therapy with efalizumab after non-response to infliximab. Acta Dermatovenerol Alp Pannonica Adriat. 2008;17:133–6.

    PubMed  Google Scholar 

  64. 64.

    Leonardi C, Langley RG, Papp K, Tyring SK, Wasel N, Vender R, et al. Adalimumab for treatment of moderate to severe chronic plaque psoriasis of the hands and feet: efficacy and safety results from REACH, a randomized, placebo-controlled, double-blind trial. Arch Dermatol. 2011;147:429–36. doi:10.1001/archdermatol.2010.384.

    CAS  Article  PubMed  Google Scholar 

  65. 65.

    Bissonnette R, Poulin Y, Bolduc C, Maari C, Provost N, Syrotuik J, et al. Etanercept in the treatment of palmoplantar pustulosis. J Drugs Dermatol. 2008;7:940–6.

    CAS  PubMed  Google Scholar 

  66. 66.

    Wollina U, Hansel G, Koch A, Schonlebe J, Kostler E, Haroske G. Tumor necrosis factor-alpha inhibitor-induced psoriasis or psoriasiform exanthemata: first 120 cases from the literature including a series of six new patients. Am J Clin Dermatol. 2008;9:1–14.

    Article  PubMed  Google Scholar 

  67. 67.

    Rallis E, Korfitis C, Stavropoulou E, Papaconstantis M. Onset of palmoplantar pustular psoriasis while on adalimumab for psoriatic arthritis: a ‘class effect’ of TNF-alpha antagonists or simply an anti-psoriatic treatment adverse reaction? J Dermatol Treat. 2010;21:3–5. doi:10.3109/09546630902882089.

    CAS  Article  Google Scholar 

  68. 68.

    Capkin E, Karkucak M, Yayli S, Aydin Capkin A, Tosun M. Infliximab-induced palmoplantar psoriasis in a patient with ankylosing spondylitis. J Clin Rheumatol. 2011;17:293–4. doi:10.1097/RHU.0b013e318228bcb6.

    Article  PubMed  Google Scholar 

  69. 69.

    Navarro R, Dauden E. Clinical management of paradoxical psoriasiform reactions during TNF-alpha therapy. Actas Dermosifiliogr. 2014;105:752–61. doi:10.1016/

    CAS  Article  PubMed  Google Scholar 

  70. 70.

    Gerdes S, Franke J, Domm S, Mrowietz U. Ustekinumab in the treatment of palmoplantar pustulosis. Br J Dermatol. 2010;163:1116–8. doi:10.1111/j.1365-2133.2010.09897.x.

    CAS  Article  PubMed  Google Scholar 

  71. 71.

    Morales-Munera C, Vilarrasa E, Puig L. Efficacy of ustekinumab in refractory palmoplantar pustular psoriasis. Br J Dermatol. 2013;168:820–4. doi:10.1111/bjd.12150.

    CAS  Article  PubMed  Google Scholar 

  72. 72.

    Au SC, Goldminz AM, Kim N, Dumont N, Michelon M, Volf E, et al. Investigator-initiated, open-label trial of ustekinumab for the treatment of moderate-to-severe palmoplantar psoriasis. J Dermatol Treat. 2013;24:179–87. doi:10.3109/09546634.2012.672710.

    CAS  Article  Google Scholar 

  73. 73.

    Lillis JV, Guo CS, Lee JJ, Blauvelt A. Increased IL-23 expression in palmoplantar psoriasis and hyperkeratotic hand dermatitis. Arch Dermatol. 2010;146:918–9. doi:10.1001/archdermatol.2010.168.

    Article  PubMed  Google Scholar 

  74. 74.

    Gottlieb A SJ, van Dorn M, et al. Secukinumab efficacy and safety in subjects with moderate to severe palmoplantar psoriasis in a phase 3b study (GESTURE). In: 23rd World Congress of Dermatology; Vancouver; 8–13 June 2015.

  75. 75.

    Reich K. Impact of ixekizumab on palmoplantar plaque psoriasis compared to placebo and etanercept: results from UNCOVER-2. In: 74th Annual Meeting of the American Academy of Dermatology; Washington, DC; 4–8 Mar 2016.

  76. 76.

    Gooderham M, Papp K. Selective phosphodiesterase inhibitors for psoriasis: focus on apremilast. BioDrugs. 2015;29(5):327–39. doi:10.1007/s40259-015-0144-3.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  77. 77.

    Paul C, Cather J, Gooderham M, Poulin Y, Mrowietz U, Ferrandiz C, et al. Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in patients with moderate-to-severe plaque psoriasis over 52 weeks: a phase III, randomized controlled trial (ESTEEM 2). Br J Dermatol. 2015;173:1387–99. doi:10.1111/bjd.14164.

    CAS  Article  PubMed  Google Scholar 

  78. 78.

    Papp K, Reich K, Leonardi CL, Kircik L, Chimenti S, Langley RG, et al. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM] 1). J Am Acad Dermatol. 2015;73:37–49. doi:10.1016/j.jaad.2015.03.049.

    CAS  Article  PubMed  Google Scholar 

  79. 79.

    Elahmed HH. Rapid improvement of palmoplantar psoriasis after cessation of smoking. Sultan Qaboos Univ Med J. 2013;13:188–9.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Tiago Torres.

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Inês Raposo has no conflict of interests to disclose.

Tiago Torres has participated in clinical trials sponsored by AbbVie, Amgen, and Novartis; and has received honoraria for acting as a consultant and/or as a speaker at events sponsored by AbbVie, Boehringer Ingelheim, Janssen, Lilly, Leo-Pharma, MSD, Novartis, and Pfizer.

No source of financial assistance was used in the preparation of this review.

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Raposo, I., Torres, T. Palmoplantar Psoriasis and Palmoplantar Pustulosis: Current Treatment and Future Prospects. Am J Clin Dermatol 17, 349–358 (2016).

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  • Psoriasis
  • Adalimumab
  • Allergic Contact Dermatitis
  • Plaque Psoriasis
  • Ustekinumab