Biologic therapies associated with development of palmoplantar pustulosis and palmoplantar pustular psoriasis: a systematic review.

Abstract

BACKGROUND:

Palmoplantar pustulosis (PPP) and palmoplantar pustular psoriasis (PPPP) are chronic inflammatory skin conditions characterized by eruptions of sterile pustules on the palms and/or soles. Biologic use has been associated with PPP and PPPP development in the literature.

OBJECTIVES:

To identify PPP and PPPP associated with biologics and summarize reported treatments and outcomes.

METHODS:

We systematically searched in MEDLINE and Embase for articles that reported PPP or PPPP during biologic treatment. After a full-text review, 53 studies were included for analysis.

RESULTS:

We identified 155 patients with PPP/PPPP onset during biologic treatment, with a mean age of 44.1 years and a female preponderance (71.6%). The most frequently reported biologics were adalimumab (43.9%) and infliximab (33.3%). IL-17 inhibitors, secukinumab (7.6%) and brodalumab (1.5%), were reported only in association with PPPP. Overall, 58.8% of patients had complete remission (CR) in 3.6 months and 23.5% had partial remission (PR) in 3.7 months. The most common treatments that led to CR were topical corticosteroids (n = 16) and biologic switching (n = 8).

CONCLUSIONS:

Clinicians should anticipate PPP or PPPP as potential drug reactions to biologics such as adalimumab and infliximab. Large-scale studies are required to confirm our findings and further explore the pathogenesis for biologic-associated PPP and PPPP.

• Authors: Justin D Lu, Yuliya Lytvyn, Asfandyar Mufti, Hiba Zaaroura, Muskaan Sachdeva, Sarah Kwan, Abrahim Abduelmula, Patrick Kim, Jensen Yeung
• Journal: International journal of dermatology (Int J Dermatol) Vol. 62 Issue 1 Pg. 12-21 (Jan 2023) ISSN: 1365-4632 [Electronic] England
• PMID: 35128653 (Publication Type: Systematic Review, Journal Article, Review)
• Copyright: © 2022 the International Society of Dermatology.

Chemical References

• Infliximab
• Adalimumab
• Biological Products

Topics

• Humans
• Female
• Adult
• Infliximab (adverse effects)
• Adalimumab (adverse effects)
• Psoriasis (pathology)
• Exanthema (therapy)
• Chronic Disease
• Biological Therapy
• Skin Diseases, Vesiculobullous (therapy)
• Acute Disease
• Biological Products (adverse effects)