Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Antoni Maria Claret 167, 08025, Barcelona, Catalonia, Spain.
Br J Dermatol. 2013 Apr;168(4):820-4. doi: 10.1111/bjd.12150.
Palmoplantar pustulosis (PPP) is characterized by sterile pustules with hyperkeratosis, erythema, scaling and fissuring on the palms and soles. PPP can present alone, or in association with palmoplantar pustular psoriasis (PPPP).
To examine treatment with ustekinumab in patients with severe refractory PPPP.
Five patients (two men and three women, age 30-50 years) with severe refractory PPPP were treated with ustekinumab, according to a pre-established protocol. A 45 mg dose of ustekinumab was administered subcutaneously, followed by a 45 mg dose 4 weeks later and every 12 weeks thereafter. The severity of involvement and the therapeutic outcome were evaluated in every patient before, during and after treatment.
Positive responses to ustekinumab were initially seen in all of the patients 2-3 weeks after the first dose, and were more remarkable after the second injection. Complete resolution of PPPP was achieved at week 20 and was maintained in all patients.
Ustekinumab appears to be an effective and safe therapeutic option in PPPP, leading to complete or nearly complete resolution of lesions and a significant improvement in patients' quality of life.
掌跖脓疱病（PPP）的特征为掌跖部出现无菌性脓疱，伴角化过度、红斑、鳞屑和皲裂。PPP 可单独发生，也可与掌跖脓疱性银屑病（PPPP）相关联。
研究乌司奴单抗治疗严重难治性 PPPP 的效果。
根据既定方案，5 名（2 男 3 女，年龄 30-50 岁）严重难治性 PPPP 患者接受乌司奴单抗治疗。患者接受皮下注射 45mg 乌司奴单抗，首次给药 4 周后给予 45mg，之后每 12 周给予一次。在治疗前、治疗中及治疗后，对每位患者的受累严重程度和治疗结果进行评估。
所有患者在首次给药后 2-3 周内最初出现对乌司奴单抗的阳性反应，第二次注射后反应更为明显。PPP 完全缓解发生在第 20 周，所有患者均维持缓解。
乌司奴单抗似乎是 PPPP 的一种有效且安全的治疗选择，可使皮损完全或几乎完全消退，并显著改善患者的生活质量。
