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KMID : 1149120180150010015
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Journal of the Korean Society for Psoriasis
2018 Volume.15 No. 1 p.15 ~ p.18
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Successful Treatment of Recalcitrant Palmoplantar Psoriasis with Secukinumab
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Lee Seon-Gu
Lee Hee-Jung
Yoon Moon-Soo
Kim Dong-Hyun
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Abstract
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Palmoplantar psoriasis (PP) is characterized by pustules, scaly erythematous plaques on the palms and soles. It is known to be difficult to treat. A 64-year-old man was diagnosed with PP 10 years ago. Initial palmoplantar pustular psoriasis area and severity index (PPPASI) was measured as 51.6. The patient also complained of pain in multiple joints. Previous treatment interventions included topical steroid/calcipotriol, narrow band UVB, cyclosporine and acitretin, but all failed to provide improvement. Adalimumab was also tried, but discontinued due to his financial problems. The treatment of subcutaneous injection of ustekinumab 45mg was started according to the treatment protocol for plaque psoriasis. After 8 weeks, 75% of the disease improved. Despite initial response, palmoplantar inflammation worsened again after 16 weeks. Subsequent adalimumab treatment for 3 months also failed. After switching from adalimumab to secukinumab, the patient achieved more than 80% clearance and has remained almost clear for more than 5 months. Herein, we report a case of PP successfully treated with secukinumab, which appears to be an effective and safe therapeutic option in PP.
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KEYWORD
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Palmoplantar psoriasis , Psoriasis , Secukinumab
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