Refractory Palmoplantar Pustular Psoriasis Treated With High-Dose Ustekinumab After Initial Failure

J Cutan Med Surg. 2019 Jan/Feb;23(1):102-104. doi: 10.1177/1203475418795823. Epub 2018 Aug 24.

Abstract

Palmoplantar pustular psoriasis (PPPP) is a form of psoriasis that can be difficult to treat. We describe a case of PPPP in a patient who failed multiple therapies, including ustekinumab. The patient subsequently developed inflammatory bowel disease (IBD), and restarting ustekinumab, with inflammatory bowel disease loading doses and optimization, resulted in complete resolution of her PPPP. This success occurred after she developed tachyphylaxis against the usual dosing of ustekinumab, demonstrating a recapture of the treatment response.

Keywords: inflammatory bowel disease; palmoplantar pustular psoriasis; ustekinumab.

Publication types

  • Case Reports

MeSH terms

  • Dermatologic Agents* / administration & dosage
  • Dermatologic Agents* / therapeutic use
  • Female
  • Foot / pathology
  • Humans
  • Inflammatory Bowel Diseases / complications
  • Middle Aged
  • Psoriasis* / complications
  • Psoriasis* / drug therapy
  • Psoriasis* / pathology
  • Skin / pathology
  • Treatment Failure
  • Ustekinumab* / administration & dosage
  • Ustekinumab* / therapeutic use

Substances

  • Dermatologic Agents
  • Ustekinumab