title: Manifestation of palmoplantar pustulosis during or after infliximab therapy for plaque-type psoriasis: report on five cases.
abstract: Infliximab is a monoclonal antibody directed against TNF-alpha. It has been approved for use in rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, psoriatic arthritis and plaque-type psoriasis. In case reports, positive effects on pustular variants of psoriasis have also been reported. However, paradoxically, manifestation of pustular psoriasis and plaque-type psoriasis has been reported in patients treated with TNF antagonists including infliximab for other indications. Here, we report on 5 patients with chronic plaque-type psoriasis who developed palmoplantar pustulosis during or after discontinuation of infliximab therapy. In two of the five cases, manifestation of palmoplantar pustulosis was not accompanied by worsening of plaque-type psoriasis. Possibly, site-specific factors or a differential contribution of immunological processes modulated by TNF inhibitors to palmoplantar pustulosis and plaque-type psoriasis may have played a role.
authors.affiliation: Department of Dermatology, Georg-August-University, Göttingen, Germany. rmoessn@gwdg.de
authors.forename: Rotraut
authors.initials: R
authors.lastname: Mössner
authors.forename: Diamant
authors.initials: D
authors.lastname: Thaci
authors.forename: Johannes
authors.initials: J
authors.lastname: Mohr
authors.forename: Sylvie
authors.initials: S
authors.lastname: Pätzold
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Bertsch
authors.forename: Ullrich
authors.initials: U
authors.lastname: Krüger
authors.forename: Kristian
authors.initials: K
authors.lastname: Reich
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D011565:Psoriasis / Q000209:etiology* / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab