Is Ustekinumab Effective for Palmoplantar Pustular Psoriasis?

Palmoplantar pustulosis (PPP) is characterized by sterile pustules, with scale, erythema, and fissuring on the palms and soles. It may be accompanied by typical psoriasis elsewhere or may occur as a complication of tumor necrosis factor α (TNF- α) antagonist therapy. Patients with PPP are exceedingly difficult to treat. Management of PPP includes topical or systemic therapies including, but not limited to, corticosteroids, vitamin D derivatives, anthralin and coal-tar preparations, photochemotherapy, localized narrowband ultraviolet B phototherapy, colchicine, tetracycline antibiotics, itraconazole, cyclosporin, methotrexate, leflunomide, acitretin, and TNF- α antagonists. Ustekinumab is a relatively new agent that is approved for use in pa…