PUVA, Etretinate, and PUVA-Etretinate Therapy for Pustulosis Palmoplantaris

Abstract

Thirty patients with severe pustulosis palmoplantaris completed a placebo-controlled comparative trial. Patients were randomly allocated to placebo or etretinate therapy; after two weeks, psoralen plus long-wave ultraviolet light (PUVA) treatment was instituted on one hand or foot, while the other hand or foot served as an untreated control. Fourteen of 18 hands or feet cleared with the combined treatment, compared with three of 18 with etretinate treatment and three of 12 with PUVA treatment. Follow-up showed a high relapse rate. Treatment of severe pustulosis palmoplantaris must be individualized to minimize short- and long-term side effects.

Epidermal Keratin Levels during Oral 1-Alpha-Hydroxyvitamin D₃ Treatment for Psoriasis

“…The results of this investigation confirm our previous findings [9] It is interesting to note that a combina tion of retinoid (etretinate) with PUVA has been tried with some success, for example in pustulosis palmoplantaris [21], On the basis of our data on the keratins, it seems likely that the two treatments have different effects and that their combination might be ex pected to produce a better effect than either singly. The interaction of different factors is complex.…”

Efficacy and safety of oral retinoids in different psoriasis subtypes: a systematic literature review

“…Among an initial selection of 1348 references, we finally included 44 references, reporting data from 37 RCTs and eight cohort studies in the systematic review 6–49 . The detailed flowchart describing both selection process and reasons for exclusion is illustrated in Fig.…”

“…Combined regimen: The combination of retinoids (etretinate 10,22,25,29,40 and acitretin 9 with PUVA has proven to be more effective in patients with palmoplantar pustular psoriasis than PUVA alone. Association of oral retinoid plus oral PUVA led to a decrease in the number of PUVA session and a reduction in cumulative dose of UVA needed for clearing 24 …”

Efficacy of fumaric acid ester monotherapy in psoriasis pustulosa palmoplantaris

“…S ir , Psoriasis pustulosa palmoplantaris (PPP) considerably affects the quality of life because of its location, its chronic course and its poor response to treatment. Treatment modalities include photochemotherapy, systemic retinoids, methotrexate and immunosuppressive drugs such as ciclosporin and mycophenolate mofetil, 1–3 which are frequently associated with serious side‐effects. Fumaric acid esters (FAE) have been shown to be safe and effective in severe plaque psoriasis 4–6 .…”