Abstract
Palmoplantar psoriasis is a chronic disabling condition characterized by erythematous scaly plaques of the palms and soles, often with associated pain, erythema, and fissuring. It is thought to occur in up to 40% of psoriasis patients, and can at times be the sole manifestation of disease. This condition poses a unique therapeutic challenge in that it is refractory to many therapies currently approved for the management of psoriasis. Recently, apremilast, a phosphodiesterase-4 inhibitor, became the first small molecule approved for the management of psoriasis and psoriatic arthritis. While showing promising results in plaque psoriasis, this therapy has yet to be fully evaluated for the management of palmoplantar psoriasis. Herein, we report a case of successful clearance of severe recalcitrant palmoplantar psoriasis using a novel combination of acitretin and apremilast.
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