Abstract
<h2>Abstract</h2> <b>Background:</b> Pustulosis palmaris et plantaris (PPP) is a chronic inflammatory disease consisting of polymorphonuclear leukocyte infiltration, and is often exacerbated by focal infections such as tonsillitis. In some cases, metal allergy has been reported. <b>Objective:</b> The purpose of this study was to evaluate (1) the significance of metal allergy in the formation of pustules, and (2) the participation of leukotriene (LT) B<sub>4</sub> in the formation of pustules of PPP. <b>Methods:</b> Patch tests with metals were performed on 7 patients with PPP, and both pustular and plasma levels of LTB<sub>4</sub> were measured in these 7 patients before and 48 hours after metal patch tests. <b>Results:</b> Palmoplantar pustules were exacerbated after the metal patch tests in all 7 patients. The mean levels of LTB<sub>4</sub> in plasma and pustules of the volar surface at 48 hours after the metal patch tests were significantly higher than those before the metal patch tests. <b>Conclusion:</b> Metals can be important in the pathogenesis of PPP by contributing to the induction of high LTB<sub>4</sub> concentration in the pustules. (J Am Acad Dermatol 2000;42:1021–5.)
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