Interventions for chronic palmoplantar pustulosis

Obeid, Grace; Do, Giao; Kirby, Lisa; Hughes, Carolyn; Sbidian, É.; Cléach, L. Le

doi:10.1002/14651858.cd011628.pub2

Cited by 25 publications

(48 citation statements)

References 101 publications

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“…According to a Cochrane systematic review on treatments for chronic PPP, data confirm the use of acitretin and oral PUVA or combination therapy, i.e., retinoid PUVA. Lowdose cyclosporin, tetracycline, and Grenz ray therapy may be beneficial for patients with PPP [97]. Methotrexate had lower efficacy in PPP and is regarded as a second-line treatment mainly in patients with concomitant psoriatic arthritis [93].…”

Section: Systemic Treatmentmentioning

confidence: 99%

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

2020

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Palmoplantar pustulosis (PPP) is a chronic, recurrent skin disease belonging to the spectrum of psoriasis. It is characterized by an eruption of sterile pustules on the palms and soles. Recent studies in PPP have focused on genetic differences between pustular phenotypes and the role of the innate immunological system and the microbiome in the etiopathogenesis of the disease. Mutations in IL36RN (a major predisposing factor for generalized pustular psoriasis) were found in selected patients with PPP and were associated with earlier disease onset. Studies have shown that the interleukin (IL)-17 and IL-36 pathways might be involved in the pathogenesis of PPP. A microbiome has been demonstrated in the vesicopustules of PPP, and an abundance of Staphylococcus appears to be increased by smoking. Improved understanding of the underlying etiopathogenesis of PPP has led to advances in treatment options, and targeted therapies for PPP have been evaluated or are under evaluation against more than 12 molecules in ongoing clinical trials.

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Section: Systemic Treatmentmentioning

confidence: 99%

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

2020

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“…78 Topical corticosteroids can cause numerous side effects, including tachyphylaxis, skin atrophy, and rebound effects. 79 Retinoids (isotretinoin, tretinoin, retinol, alitretinoin, adapalene, retinaldehyde, and tazarotene) are also often used. The most common adverse effect is an irritation that is experienced during the beginning of treatment.…”

Section: Quality Of Life and Psychiatric Disordersmentioning

confidence: 99%

“…Pregnancy is a contraindication. 79 New drugs are in clinical trials for the efficient treatment of the disease, namely, a third-generation cephalosporin, the cefcapene pivoxil hydrochloride, and the maxacalcitol (22oxacalcitriol). 80 Studies presented the topical maxacalcitol efficacy.…”

Section: Quality Of Life and Psychiatric Disordersmentioning

confidence: 99%

“…A Cochrane systematic review found with lowquality evidence that maxacalcitol (topical vitamin D) might be more effective in clearing or almost clearing status than placebo and the risk of side effects (such as pruritus, mild local irritation, and urinary or haematological test abnormalities) is presumably comparable in both groups. 79 It is contraindicated in hypercalcemia, pregnancy, lactation, and hepatic and renal failure. 79 Beyond this, there is a case report that observed improvement in PPP lesions with a topical phosphodiesterase-4 inhibitor, crisaborole and another case report that also showed improvements with the use 1% twice a day of tacrolimus ointment.…”

Section: Quality Of Life and Psychiatric Disordersmentioning

confidence: 99%

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<p>Diagnosis, Screening and Treatment of Patients with Palmoplantar Pustulosis (PPP): A Review of Current Practices and Recommendations</p>

Freitas¹,

Rodrigues²,

Torres³

2020

CCID

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Palmoplantar pustulosis (PPP) is a rare, chronic, recurrent inflammatory disease that affects the palms and/or the soles with sterile, erupting pustules, which are debilitating and usually resistant to treatment. It has genetic, histopathologic and clinical features that are not present in psoriasis; thus, it can be classified as a variant of psoriasis or as a separate entity. Smoking and upper respiratory infections have been suggested as main triggers of PPP. PPP is a challenging disease to manage, and the treatment approach involves both topical and systemic therapies, as well as phototherapy and targeted molecules. No gold standard therapy has yet been identified, and none of the treatments are curative. In patients with mild disease, control may be achieved with on-demand occlusion of topical agents. In patients with moderate-to-severe PPP, phototherapy or a classical systemic agent (acitretin being the best treatment option, especially in combination with PUVA) may be effective. Refractory patients or those with contraindications to use these therapies may be good candidates for apremilast or biologic therapy, particularly anti-IL-17A and anti-IL-23 agents. Recent PPP trials are focusing on blockage of IL-36 or IL-1 pathways, which play an important role in innate immunity. Indeed, IL-36 isoforms have been strongly implicated in the pathogenesis of psoriasis. Therefore, blockage of the IL-36 pathway has become a new treatment target in PPP, and three studies are currently evaluating the use of monoclonal antibodies that block the IL-36 receptor in PPP: ANB019 and spesolimab (BI 655130). In this review, we explore the diagnosis, screening and treatment of patients with PPP.

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“…Zusätzlich erschwert der Mangel allgemein gültiger Scoring-Instrumente der PPP die Vergleichbarkeit der wenigen, bisher publizierten Arbeiten. Lediglich die Wirkung von Secukinumab und Guselkumab auf die PPP in der für die Plaque-Psoriasis zugelassenen Dosis ist hinreichend belegt [31]. Naheliegend ist, eine Effektivität in der Behandlung der PPP auch für die übrigen Wirkstoffe aus den Gruppen der IL-17-und IL-23-Inhibitoren anzunehmen [32].…”

Section: B) Krankheitsspezifische Aspekteunclassified

Etablierung des Schwerpunktes Psoriasis an der Universitätshautklinik Rostock und eine praxisbezogene Übersicht über die Biologikatherapie der Psoriasis

Grünwald

Krebs

Troitzsch

et al. 2020

Aktuelle Dermatologie

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ZusammenfassungDie Diagnostik und Behandlung der Psoriasis stellt einen Schwerpunkt an der Universitätshautklinik Rostock dar. Aufgrund des breiten Spektrums verfügbarer Biologikatherapien für die Behandlung der Psoriasis werden in diesem Artikel praxisbezogene Ratschläge für diese Therapieform gegeben. Dabei wird aufgezeigt, wie das optimale Biologikum für einen individuellen Patienten unter Berücksichtigung möglicher Kontraindikationen, krankheitsspezifischer Aspekte und unerwünschter Wirkungen ausgewählt werden kann. Außerdem wird ein mögliches Vorgehen bei Unterbrechung, Wiederaufnahme oder Umstellung von Biologika erwähnt.

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Interventions for chronic palmoplantar pustulosis

Abstract: Interventions for chronic palmoplantar pustulosis (Review)

Cited by 25 publications

References 101 publications

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments

<p>Diagnosis, Screening and Treatment of Patients with Palmoplantar Pustulosis (PPP): A Review of Current Practices and Recommendations</p>

Etablierung des Schwerpunktes Psoriasis an der Universitätshautklinik Rostock und eine praxisbezogene Übersicht über die Biologikatherapie der Psoriasis

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