Palmoplantar Psoriasis and Palmoplantar Pustulosis: Current Treatment and Future Prospects.
Palmoplantar psoriasis and palmoplantar pustulosis are chronic skin diseases with a large impact on patient quality of life. They are frequently refractory to treatment, being generally described as a therapeutic challenge. This article aims to review the definitions of palmoplantar psoriasis and palmoplantar pustulosis, highlighting the similarities and differences in terms of epidemiology, clinical presentation, genetics, histopathology, and pathogenesis, as well as treatment options for both entities. Classical management of mild to moderate palmoplantar pustulosis and palmoplantar psoriasis relies on use of potent topical corticosteroids, phototherapy, and/or acitretin. Nevertheless, these drugs have proven to be insufficient in long-term control of extensive disease. Biologic therapy-namely, anti-interleukin-17 agents and phosphodiesterase type 4 inhibitors-has recently shown promising results in the treatment of palmoplantar psoriasis. Knowledge of the pathophysiologic pathways of both entities is of utmost importance and may, in the future, allow development of molecularly targeted therapeutics.
Department of Dermatology, Centro Hospitalar do Porto, Edifício das Consultas Externas, Ex-CICAP, Rua D. Manuel II, s/n, 4100, Porto, Portugal.
Inês
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Raposo
Department of Dermatology, Centro Hospitalar do Porto, Edifício das Consultas Externas, Ex-CICAP, Rua D. Manuel II, s/n, 4100, Porto, Portugal. torres.tiago@outlook.com.|Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal. torres.tiago@outlook.com.
Tiago
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Torres
D017255:Acitretin / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001688:Biological Products / Q000627:therapeutic use; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000627:therapeutic use; D006229:Hand Dermatoses / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D010789:Phototherapy; D011565:Psoriasis / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life
D000305:Adrenal Cortex Hormones; D001688:Biological Products; D003879:Dermatologic Agents; D017255:Acitretin