Adalimumab in the Management of Palmoplantar Psoriasis

December 2009 | Volume 8 | Issue 12 | Case Reports | 1136 | Copyright © December 2009

Jayashri V. Ghate MD and Carrie D. Alspaugh MD FAAD

Abstract
Palmoplantar pustular psoriasis (PPP) is an uncommon form of chronic psoriasis. Characterized by sterile, intra-epidermal pustules located on the palms and soles, it is highly resistant to treatment. A patient presented with palmar inflammation and throbbing joint pain in his hands, as well as erythematous, pustular, and micaceous scaling skin on his right foot, legs, elbows and hands. Approximately 4% of his body surface area was involved, and he was diagnosed with PPP after skin biopsy. After conventional therapy failed, the patient underwent treatment with adalimumab and the majority of his symptoms resolved after 16 weeks of therapy. Adalimumab may be effective for the treatment of PPP. Adalimumab, a fully human, immunoglobulin G1 monoclonal antibody that binds to tumor necrosis factor, has been approved for the treatment of moderate-to-severe psoriasis, in the U.S., Europe and elsewhere.