Practical Experience with Efalizumab in Hand and Foot Psoriasis

Psoriasis of the hands and feet is highly debilitating and difficult to treat. It may be of a plaque-or pustular-type, or a combination of the two. Efalizumab (Raptiva®, Genentech Inc), a humanized monoclonal antibody that inhibits critical T cellmediated processes, is approved by the FDA for the treatment of adult patients with chronic moderate to severe plaque psoriasis. We present the cases of 7 patients who suffered from extensive hand and foot psoriasis recalcitrant to treatment. Each patient was treated with 1 mg/kg/wk of efalizumab and responded rapidly to treatment with favorable results appearing within 1 to 4 months. Patients were able to resume previous work responsibilities and no longer suffered from difficulties with ambulation. Efalizumab was effective for the rapid treatment of these 7 patients with psoriasis of the hands and feet.