A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients
Article first published online: 11 MAR 2009
© 2009 The Authors. Journal compilation © 2009 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 23, Issue 7, pages 814–819, July 2009
How to Cite
Adışen, E., Tekin, O., Gülekon, A. and Gürer, M. (2009), A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients. Journal of the European Academy of Dermatology and Venereology, 23: 814–819. doi: 10.1111/j.1468-3083.2009.03197.x
- Issue published online: 3 JUN 2009
- Article first published online: 11 MAR 2009
- Received: 28 August 2008; Accepted 16 December 2008
- cyclosporine and retinoids;
- palmoplantar psoriasis;
- palmoplantar pustular psoriasis;
- systemic treatment;
- topical corticosteroids
Background Treatment options remain unsatisfactory for patients with palmoplantar psoriasis (PP) and palmoplantar pustular psoriasis (PPP).
Aim To evaluate the therapeutic responses of PP and PPP patients that were treated in our psoriasis polyclinic between 2003 and 2007.
Methods This retrospective study comprised PP (n = 62) and PPP (n = 52) patients. Treatments were individualized according to patient compliance and associating systemic diseases. The effect of systemic treatments was grouped as follows: ‘no improvement’: patients unresponsive for the present treatment; ‘partial improvement’: < 50% decrease in severity or affected area; ‘moderate improvement’: 50–75% decrease in severity or affected area, and ‘marked improvement’: > 75% decrease of the disease compared to baseline.
Results In the PP group, 17 of 62 patients showed marked improvement to topical agents, while the remaining patients required systemic agents including oral retinoids (n = 24), local psoralen plus ultraviolet A (PUVA; n = 12), methotrexate (n = 9) and cyclosporine (n = 2). Marked improvement was achieved in 53%, 45%, 47% and 100%, respectively. In these patients, two (n = 10), three (n = 5), or four (n = 5) systemic agents were used alternately.
In the PPP group, 18 of 52 patients achieved marked improvement by topical agents. Patients that required systemic agents were treated with colchicum (n = 19), local PUVA (n = 8), methotrexate (n = 4), oral retinoids (n = 3) and cyclosporine (n = 2). These treatments achieved a marked improvement in 60%, 33%, 57%, 83%, and 50% of the patients, respectively. In the course of the disease, 18 patients required two and 3 patients required three systemic agents alternately.
Conclusions Although the success rates appeared to be high, the high number of patients who required multiple systemic agents emphasized the fact that localized forms of psoriasis were resistant to therapy.
Conflicts of interest