Murakami Masamoto, Terui Tadashi
Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan.
Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan.
J Dermatol Sci. 2020 Apr;98(1):13-19. doi: 10.1016/j.jdermsci.2020.03.003. Epub 2020 Mar 14.
Pustulosis palmaris et plantaris, or palmoplantar pustulosis (PPP), is a chronic pustular dermatitis involving the palms and soles and is characterized by vesicles, pustules, erythema, lichenification, and abnormal desquamation. It is one of the most common skin diseases in Japan but its pathomechanism is unclear and the disease remains poorly defined. Consequently, adequate treatment for PPP is lacking. As a localized type of pustular psoriasis, PPP has long been treated with the conventional therapies used for plaque-type psoriasis, especially in Western countries. However, PPP may be a distinct entity, with a much lower prevalence in Western countries than in Japan. Furthermore, while treatment has yielded insights into the underlying pathology in plaque-type psoriasis, the pathogenesis of PPP has yet to be elucidated. In 2018, Gulselkumab, a monoclonal antibody against interleukin (IL)-23, was certified for use in Japan and is the first biologic effective in PPP both in Japanese and other patients. In this review, we summarize the current understanding of PPP, including the revised definition and possible pathomechanism. The information presented herein provides a more complete picture of PPP and may facilitate the development of improved treatment options.
掌跖脓疱病，即掌跖脓疱性皮病（PPP），是一种累及手掌和足底的慢性脓疱性皮炎，其特征为水疱、脓疱、红斑、苔藓样变及异常脱屑。它是日本最常见的皮肤病之一，但其发病机制尚不清楚，该疾病的定义仍不明确。因此，缺乏针对PPP的充分治疗方法。作为脓疱型银屑病的一种局限性类型，长期以来，PPP一直采用用于斑块型银屑病的传统疗法进行治疗，尤其是在西方国家。然而，PPP可能是一种独特的疾病实体，在西方国家的患病率远低于日本。此外，虽然针对斑块型银屑病的治疗已为潜在病理学提供了一些见解，但PPP的发病机制仍有待阐明。2018年，抗白细胞介素（IL）-23单克隆抗体古塞库单抗在日本获批使用，它是首个对日本患者和其他患者的PPP均有效的生物制剂。在本综述中，我们总结了目前对PPP的认识，包括修订后的定义和可能的发病机制。本文提供的信息能更全面地展现PPP，可能有助于开发更好的治疗方案。
