Similarity and difference between palmoplantar pustulosis and pustular psoriasis

Yamamoto, Toshiyuki

doi:10.1111/1346-8138.15826

Cited by 33 publications

(47 citation statements)

References 105 publications

(171 reference statements)

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“…The appropriate classification of PPP and its inclusion within the spectrum of PP are still controversial. Japanese authors tend to consider PPP as a distinct nosological entity, in contrast with others, mainly outside of Japan, who regard PPP as synonymous with PPPP [4,[6][7][8]. Emerging differences in genetic background, comorbidities and precipitating factors seem to favor the first hypothesis in the opinion of some authors [4].…”

Section: Nosological Aspectsmentioning

confidence: 99%

“…Japanese authors tend to consider PPP as a distinct nosological entity, in contrast with others, mainly outside of Japan, who regard PPP as synonymous with PPPP [4,[6][7][8]. Emerging differences in genetic background, comorbidities and precipitating factors seem to favor the first hypothesis in the opinion of some authors [4]. PPP is sometimes referred to as PPPP in the presence of concomitant PV and/or a family history of PV [1,9,10].…”

Section: Nosological Aspectsmentioning

confidence: 99%

“…Some nosological aspects of PP are still debated. The classification of PP distinguishes localized variants [palmoplantar PP (PPPP) and acrodermatitis continua of Hallopeau (ACH)], and generalized variants, i.e., acute generalized PP (GPP), PP of pregnancy [also known as impetigo herpetiformis (IH)], annular (and circinate) and infantile/juvenile PP [ 1 , 4 ]. Localized forms of annular PP also exist [ 4 ].…”

Section: Nosological Aspectsmentioning

confidence: 99%

“…PPP typically affects middle aged women, especially smokers [ 8 , 13 , 50 ]. Possible comorbidities are arthro-osteitis, metabolic syndrome and thyroid disease [ 4 , 10 , 50 ]. The Japanese literature reports that around 30% of PPP patients develop musculoskeletal manifestations [ 9 ].…”

Section: Nosological Aspectsmentioning

confidence: 99%

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Pustular Psoriasis: From Pathophysiology to Treatment

Genovese

Moltrasio

Cassano³

et al. 2021

Biomedicines

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Pustular psoriasis (PP) is a clinicopathological entity encompassing different variants, i.e., acute generalized PP (GPP), PP of pregnancy (impetigo herpetiformis), annular (and circinate) PP, infantile/juvenile PP, palmoplantar PP/palmoplantar pustulosis, and acrodermatitis continua of Hallopeau (ACH), which have in common an eruption of superficial sterile pustules on an erythematous base. Unlike psoriasis vulgaris, in which a key role is played by the adaptive immune system and interleukin (IL)-17/IL-23 axis, PP seems to be characterized by an intense inflammatory response resulting from innate immunity hyperactivation, with prominent involvement of the IL-36 axis. Some nosological aspects of PP are still controversial and debated. Moreover, owing to the rarity and heterogeneity of PP forms, data on prognosis and therapeutic management are limited. Recent progresses in the identification of genetic mutations and immunological mechanisms have promoted a better understanding of PP pathogenesis and might have important consequences on diagnostic refinement and treatment. In this narrative review, current findings in the pathogenesis, classification, clinical features, and therapeutic management of PP are briefly discussed.

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Section: Nosological Aspectsmentioning

confidence: 99%

Section: Nosological Aspectsmentioning

confidence: 99%

Section: Nosological Aspectsmentioning

confidence: 99%

Section: Nosological Aspectsmentioning

confidence: 99%

See 2 more Smart Citations

Pustular Psoriasis: From Pathophysiology to Treatment

Genovese

Moltrasio

Cassano³

et al. 2021

Biomedicines

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show abstract

“…[1][2][3][4][5][6][7] Many aspects of PPP resemble those of psoriasis, and shared pathogenesis has been suggested between PPP and psoriasis, either plaque-type or pustular-type. 8 One of the important differences between PPP and psoriasis is that PPP is closely related to focal infection and thus treatment of ie tonsillar and dental infection is preferentially required. However, some patients develop PPP without having focal infection.…”

Section: Introductionmentioning

confidence: 99%

Guselkumab for the Treatment of Palmoplantar Pustulosis: A Japanese Perspective

Yamamoto¹

2021

CPAA

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Palmoplantar pustulosis (PPP) is a chronic inflammatory disorder characterized by sterile pustules predominantly involving the palms and soles. PPP is refractory to various therapies such as topical ointment, oral medicine, and phototherapies. Pustulotic arthro-osteitis (PAO) is a major comorbidity of PPP that severely impairs patients’ quality of life. Recently, guselkumab, a monoclonal antibody against IL-23, has been available for the treatment of PPP in Japan. The purpose of the present review is to describe the characteristics of Japanese PPP patients and biologic therapy of PPP/PAO using guselkumab. Most Japanese dermatologists consider PPP as a distinct entity and co-existence of PPP and psoriasis is rare. However, outside Japan, PPP is often considered to be palmoplantar psoriasis, and extra-palmoplantar lesions associated with PPP are regarded as psoriasis. PPP develops or exacerbates either with or without arthralgia, following focal infections, such as tonsillitis, odontogenic infection, and sinusitis. Treatment of focal infection results in dramatic effects on cutaneous lesions as well as joint pain. By contrast, we sometimes see patients whose skin/joint symptoms do not improve after treatment of focal infection, whose focus of infection cannot be identified even in a detailed examination, and/or who refuse tonsillectomy even if strongly recommended. Such cases are considered to be indications of biologics. In this review, clinical features, pathophysiology and guselkumab therapy are discussed.

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Effect of guselkumab on serum biomarkers in Japanese palmoplantar pustulosis patients in a randomized phase 3 study

Morita

Chen

Leung

et al. 2022

JEADV Clinical Practice

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Background It is reported that treatment of palmoplantar pustulosis (PPP) with guselkumab has greater improvement in clinical responses in terms of palmoplantar pustulosis area severity index (PPPASI) score. Here, we present the effect of guselkumab (100 and 200 mg) on PPP‐related serum proteins and their association with clinical responses. Objectives To analyze the effects of guselkumab treatment on PPP‐related circulating serum proteins up to Week 72 and evaluate their association with clinical responses. Methods Serum cytokines (interleukin [IL]‐17A, IL‐17F, IL‐22, tumour necrosis factor‐alpha, interferon‐gamma) and 184 inflammation/immune activation‐related serum proteins were evaluated. Baseline cytokine levels for patients with PPP were compared with healthy controls (HCs) to detect differentially expressed serum proteins using Welch's t‐test. Correlation with individual PPPASI scores was assessed to explore associations with disease severity. Guselkumab treatment‐associated pharmacodynamic (PD) effects were evaluated as fold changes in cytokine levels compared with baseline. Results Baseline serum IL‐17A, IL‐17F and IL‐22 levels were elevated in PPP patients (n = 159) compared with HCs (n = 25) and were significantly correlated with baseline PPPASI disease scores. Serum cytokines were reduced following guselkumab treatment, with maximal reduction at Week 72 for both doses (all p < 0.01). Lower levels of IL‐17A, IL‐17F and IL‐22 were associated with PPPASI improvement at Week 72. Olink platform analysis identified a decrease in chemokine ligand‐19 and IL‐6 levels with guselkumab compared with placebo. However, the difference between the treatment groups was not significant. The biomarker effect of guselkumab 100 versus 200 mg groups was comparable, suggesting the PD effect is plateaued and higher than 200 mg is unlikely to increase biomarker changes. Conclusions Targeting IL‐23 with guselkumab in PPP led to a progressive reduction in IL‐17A, IL‐17F and IL‐22 in serum, and lower serum levels of these Th17/Th22 cytokines were associated with better PPPASI response after treatment. Clinical Trials.gov identifier NCT02641730.

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Similarity and difference between palmoplantar pustulosis and pustular psoriasis

Cited by 33 publications

References 105 publications

Pustular Psoriasis: From Pathophysiology to Treatment

Pustular Psoriasis: From Pathophysiology to Treatment

Guselkumab for the Treatment of Palmoplantar Pustulosis: A Japanese Perspective

Effect of guselkumab on serum biomarkers in Japanese palmoplantar pustulosis patients in a randomized phase 3 study

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