Palmoplantar Involvement Research Articles

Efficacy of Ixekizumab in Chinese Patients with Moderate-to-Severe Psoriasis and Special Body Area Involvement: Sub-analysis of a Randomized, Double-Blind, Multicenter Phase 3 Study.

Special body area involvement is common in psoriasis and can be challenging to treat. We investigated the efficacy of ixekizumab (IXE) in Chinese patients with moderate-to-severe psoriasis and fingernail, scalp, or palmoplantar involvement. A post-hoc sub-analysis of a phase 3 trial, in which patients were randomized to receive placebo, IXE 80mg every 2 (IXE Q2W) or 4 (IXE Q4W) weeks. At Week 12, patients classified as IXE responders [static Physician's Global Assessment (sPGA) score of 0 or 1 [0,1)] were re-randomized (2:1) to IXE Q4W or placebo until Week 60. Efficacy was assessed by body-regionspecific parameters including Nail Psoriasis Severity Index (NAPSI), Psoriasis Scalp Severity Index (PSSI), and Palmoplantar Psoriasis Area Severity Index (PPASI). Of 438 patients, 99.1% (434) had≥1 special area involvement [fingernail (76.5%, 335), scalp (97.3%, 426), palmoplantar (27.9%, 122)]. Significantly greater improvements from baseline in NAPSI score were observed with IXE Q4W and Q2W at Week 12 versus placebo (p<0.001 for both). These improvements were further increased and sustained over 60weeks in IXE Q4W and Q2W responders who were re-randomized to IXE Q4W, who achieved a 77.9% and 89.7% improvement from baseline, respectively, at Week 60. Significantly higher proportions of patients receiving IXE Q4W and Q2W achieved NAPSI 50 at Week 12 versus placebo (44.4%, 36.6% vs. 14.1%; p<0.001 and<0.01, respectively). Similarly, significantly higher proportions of patients receiving IXE Q4W and Q2W achieved PSSI 100 and PPASI 100 at Week 12 versus placebo (60.6% and 65.1% vs. 1.2%, and 67.4%, 84.3% vs. 21.4%, respectively; p<0.001 for all comparisons). Improvements across all outcomes were sustained in patients re-randomized to IXE Q4W until Week 60. IXE led to a rapid onset of action and sustained efficacy over 60weeks in Chinese patients with moderate-to-severe psoriasis and special body area involvement. gov identifier, NCT03364309.

51675 Safety and efficacy of risankizumab in adult patients with moderate-to-severe plaque psoriasis with non-pustular palmoplantar involvement: changes in PPASI and PASI from Phase 3b IMMprint trial

51675 Safety and efficacy of risankizumab in adult patients with moderate-to-severe plaque psoriasis with non-pustular palmoplantar involvement: changes in PPASI and PASI from Phase 3b IMMprint trial

51652 Safety and efficacy of risankizumab in adult patients with moderate to severe plaque psoriasis with non-pustular palmoplantar involvement: change in DLQI and achievement of DLQI 0/1 results from the Phase 3b IMMprint trial

51652 Safety and efficacy of risankizumab in adult patients with moderate to severe plaque psoriasis with non-pustular palmoplantar involvement: change in DLQI and achievement of DLQI 0/1 results from the Phase 3b IMMprint trial

Benefits Over Five Years of Ixekizumab Treatment in Patients With Psoriasis Involving Challenging Body Areas.

Psoriasis involving challenging body areas, such as the scalp, face, palmoplantar surfaces, or nails, can be challenging to treat and negatively affects patient outcomes. To assess clear responses and cumulative clinical benefits over 5 years of ixekizumab treatment of moderate-to-severe plaque psoriasis in patients with and without baseline involvement of challenging body areas. This post hoc analysis included patients treated with ixekizumab in the UNCOVER-3 trial. We assessed PASI100 responses through the week (W) 264 and cumulative clinical benefits at W264 (calculated as least-squares mean of the percentage of maximum area under the curve for PASI100 and PASI% improvement and expressed as cumulative clearance days). Statistical differences were calculated via ANCOVA. A total of 385 patients were analyzed: 349 with scalp involvement, 152 with facial involvement, 96 with palmoplantar involvement, and 229 with nail involvement. Proportions of patients achieving PASI100 were numerically similar between patients with and without scalp and nail involvement. More patients without facial and palmoplantar involvement achieved PASI100 at W60 (only palmoplantar), W108, W156, W204, and W264 (only palmoplantar). At W264, cumulative clinical benefits for PASI100 and PASI% improvement were high and similar in both patient groups, with and without challenging body areas. A significant difference (P=0.006) was only observed for PASI% improvement between patients with and without nail involvement. For most efficacy measures, patients treated with ixekizumab over 5 years achieved similar clear responses and cumulative clinical benefits regardless of baseline involvement of challenging body areas. J Drugs Dermatol. 2024;23(8):619-625.&nbsp; doi:10.36849/JDD.8160.

A randomized phase 3b study evaluating the safety and efficacy of risankizumab in adult patients with moderate-to-severe plaque psoriasis with non-pustular palmoplantar involvement

BackgroundIn plaque psoriasis, palmoplantar areas are more difficult to treat. ObjectiveEvaluate the safety and efficacy of risankizumab (RZB) versus placebo (PBO) for the treatment of palmoplantar psoriasis (PPPsO). MethodsPatients were randomized to RZB or PBO for 16 weeks followed by RZB through week 52. The primary and secondary endpoints were achievement of palmoplantar Investigator’s Global Assessment of “clear” or “almost clear” with ≥2-point reduction from baseline (ppIGA 0/1), achievement of ≥75%, ≥90% and 100% improvement in Palmoplantar Psoriasis Area and Severity Index (PPASI 75, PPASI 90, PPASI 100) and achievement of static Physician Global Assessment of "clear" or "almost clear" with ≥2-point reduction from baseline (sPGA 0/1) at week 16. Safety was based on treatment-emergent adverse events (TEAEs). ResultsRZB demonstrated significant efficacy compared to PBO at week 16 in the patients achieving ppIGA 0/1 (33.3% vs 16.1% [P = .006]), PPASI 75 (42.5% vs 14.9% [P < .001]), PPASI 90 (27.6% vs 5.7% [P < 0.001]), sPGA 0/1 (32.2% vs 11.5% [P < .001]) and PPASI 100 (17.2% vs 1.1% [P < .001]). Results improved through week 52 with no new safety signals. LimitationNo biologic comparator ConclusionsRZB demonstrated safety and efficacy in PPPsO.

Long-term drug survival of risankizumab in psoriasis: insights from a real-life multicenter study on hard-to-treat areas.

Psoriasis, a chronic inflammatory condition, often presents challenges in treatment, particularly in areas such as nails, palms/soles, scalp/face, and genitalia. Monoclonal antibodies (mAb) like risankizumab targeting interleukin-23 (IL-23) have emerged as promising treatments, yet data on long-term efficacy remain limited. This multicenter retrospective study aimed to evaluate the drug survival at 12 and 36 months of 191 psoriasis patients treated with risankizumab, focusing on critical areas. Patients, previously unresponsive to first-line therapies, were treated according to Italian Guidelines. Survival analysis revealed a 97.6% one-year and 95% three-year drug survival rate. Secondary ineffectiveness was the primary reason for discontinuation, particularly in palmoplantar involvement cases. Factors such as BMI, gender, age, disease duration, baseline severity, and previous biologic exposure did not significantly impact drug survival, except for palmoplantar psoriasis (HR 4.72). Risankizumab demonstrated prolonged response with low treatment switch requirements, especially notable in challenging areas. Understanding such factors can aid in optimizing therapeutic approaches for improved patient care and long-term outcomes in managing psoriasis. Further research is warranted to refine treatment strategies in difficult-to-treat areas.

Uncommon toxic epidermal necrolysis -like presentation of cutaneous lupus erythematosus: A series of 6 cases.

TEN like Lupus erythematosus is an uncommon life-threatening variant of Lupus erythematosus. It is usually associated with flares of systemic lupus erythematosus and also because of widespread skin erosions, it can cause acute skin failure. It is often confused with drug induced TEN, however the management of both the diseases is different and hence correct diagnosis becomes crucial. In this study we aimed to assess the clinical characteristics and outcome of TEN like LE in the Indian population. All patients satisfying ACR/EULAR 2019 criteria for SLE and clinically diagnosed with TEN like LE were retrospectively reviewed. A total of 6 patients were identified. All patients were female. Except 1 patient who presented de-novo, the others had pre-existing symptoms of connective tissue disease. Half of the patients had palmoplantar involvement. Mucosal involvement was only mild. Majority had systemic involvement in the form of nephritis followed by arthralgia, autoimmune hepatitis and autoimmune hemolytic anemia.

Les défis de la prise en charge de la variole du singe dans un pays en voie de développement : cas du Cameroun

International interest has been focused on Monkeypox since July 2022, due to multiples cases reported outside Africa. We report a case that occurred in Cameroon during this period. A 40-year-old Patient, heterosexual, living in Tombel in the southwest of Cameroon, HIV positive, consulted on 02/10/2022 for umbilicated, confluent vesiculo-pustular lesions, confluent on the face and scalp with palmo-plantar involvement, without lymphadenopathy, febrile, and evolving for 2 weeks. The diagnosis of Monkeypox was made based on a positive PCR test from on a skin sample revealing the Monkeypox clade 2 virus. Under treatment, the evolution was favourable after 17 days. We report the first confirmed case of Monkeypox in the city of Douala. The major challenge for the government would be to develop diagnostic and response strategies, to contain and neutralize the disease.

Drug survival of biologics and non-biologics in patientsaffected by palmoplantar psoriasis: a "real-world", mono-center experience.

Data on the treatment of palmoplantar psoriasis (PP) are very limited as these patients are often excluded from clinical trials. Moreover, this form of psoriasis is often resistant to treatment, making its clinical management complex. Primary endpoint was to evaluate the clinical and demographic characteristics and the drug survival of both biological and non-biological drugs in a population affected by PP. Secondary endpoint was to highlight any differences between the hyperkeratotic and pustular variant. We analyzed data from 233 psoriasis patients with palmoplantar involvement, with or without chronic plaque psoriasis. We performed a drug-survival analysis with the aid of Kaplan-Meier survival and a multivariate analysis to highlight the influence of certain variables on treatment persistence using a Cox regression model. The drug-survival analysis revealed that biologic drugs compared to non-biologic drugs are associated with a higher persistence in treatment (59.73 vs. 43.56%); in particular, anti-IL23 drugs were found to be the drugs with the best drug-survival overall (67.94% of patients at 60 months are still on these drugs). Furthermore, our multivariate analysis shows that when compared with biological drugs, non-biological drugs are associated with an increased risk of treatment discontinuation (HR = 1.95 [95% CI: 1.41-2.68], P = 0.001). Our study confirms the difficulty of treating PP and shows that biologic drugs are associated with longer persistence in treatment than non-biologics in both PP's variants, not because of their higher effectiveness but because of their better safety profile.

Exantema en enfermedad por virus de inmunodeficiencia humana, ¿manifestación de infección o reacción alérgica?

A male patient presented with a maculopapular, non-pruritic rash, without palmoplantar involvement, after receiving treatment with trimethoprim/sulfamethoxazole for seven days due to gastrointestinal symptoms. After taking a complete medical history and using fourth-generation tests confirmed HIV infection. On the fifth day of antiretroviral treatment, he presented new erythematous lesions with thick, pruritic scaling, facial edema and eosinophilia. A skin biopsy reported lichenoid dermatitis, with spongiosis, vacuolar degeneration of the basal layer, necrotic keratinocytes and eosinophil infiltrate, characteristics that favor drug reaction. The treatment consisted of interrupting the combined therapy, using systemic corticosteroids, antihistamines and since it was not a severe condition, antiretroviral treatment restarted without complications.

A Phase 3b Study Evaluating Safety and Efficacy of Risankizumab in Adult Patients with Moderate-to-Severe Plaque Psoriasis with Palmoplantar (Non-Pustular) Involvement

Introduction: We evaluate safety and efficacy of risankizumab (RZB) vs. placebo (PBO) in adult patients with moderate-to-severe non-pustular palmoplantar psoriasis (PPPsO).&#x0D; Method: IMMprint, a Ph3b study evaluated safety and efficacy of RZB vs. PBO in moderate-to-severe PPPsO patients with a static physician’s global assessment(sPGA) of moderate or severe ≥3, palmoplantar psoriasis area and severity index(PPASI) ≥8 and at least 1 additional PsO plaque. The 52-week treatment was split into period A, patients randomized (1:1) to RZB 150-mg or PBO, and period B, patients continuing RZB or switching from PBO to RZB (PBO/RZB). Primary endpoint was achievement of palmoplantar investigator’s global assessment (ppIGA) 0/1 with at least 2-point reduction from baseline at Wk16. Ranked secondary endpoints include ≥75% &amp; 90% improvement in PPASI (PPASI75, PPASI90), sPGA 0/1 and 100% improvement in PPASI(PPASI100) at Wk16.&#x0D; Results: Of 174 enrolled, 87(mean age[SD]: 56.9[12.9] years) were randomized to RZB and 87(mean age[SD]: 53.9[14.3] years) were randomized to PBO. Baseline characteristics were similar except for numerical difference in PsA (RZB vs. PBO: 11.5% vs 4.6%, respectively). At Wk16, a significantly higher proportion receiving RZB achieved ppIGA 0/1 than PBO(33.3% vs. 16.1%, p = 0.006). Patients receiving RZB also demonstrated significantly higher responses than patients receiving PBO in all ranked secondary endpoints: PPASI75 (42.5% vs 14.9%, P &lt; 0.001); PPASI90 (27.6% vs 5.7%, p&lt;0.001); sPGA 0/1 (32.2% vs 11.5%, p &lt; 0.001); and PPASI100 (17.2% vs. 1.1%, p &lt; 0.001). Four patients (3 RZB: 1 PBO) discontinued drug in period A. At Wk52, ppIGA 0/1 was achieved by 50.6% of RZB patients and 61.7% of PBO/RZB group. Proportion of patients achieving PPASI75 at Wk52 was 57.5%(RZB) vs. 65.4% (PBO/RZB). Achievement of sPGA 0/1 (%RZB vs. %PBO/RZB) was 43.7% vs. 66.7%; PPASI100 was achieved by 26.4% (RZB) and 37.0% (PBO/RZB) patients at Wk52. Proportion of patients with adverse events were 29.1%(RZB) and 23.0%(PBO) in period A, and 49.4%(RZB) and 35.8% (PBO/RZB) in period B. One RZB patient with prior cardiovascular risk factors had an adjudicated myocardial infarction and subsequently died after 140-day follow-up period. The number of patients with COVID-19 were 3 (RZB; 1 serious infection) and 2(PBO) in period A and 11 (RZB) and 7 (PBO/RZB) in period B.&#x0D; Conclusion: This study demonstrates RZB can provide effective improvement compared to PBO by Wk16 with continuous improvement until Wk52 with no new safety signals in patients with moderate-to-severe PPPsO.

Syphilis Resurrected: Case Series of Palmoplantar Secondary Syphilis.

Introduction Syphilis is a sexually transmitted infection caused by Treponema pallidum which has protean manifestations. The cutaneous presentation of syphilis can mimic many dermatologic conditions. Materials & methods With an aim to describe palmoplantar involvement in syphilis, a retrospective study of case series was done with 11 patients having palmoplantar skin lesions in syphilis within a period of two years. Only serologically confirmed cases were included. Results The prevalence of palmoplantar involvement in syphilis was 47.85% and all of them except one patient (congenital syphilis) were secondary syphilis. A major proportion of cases (72.8%) studied had no history or presentation of genital lesions. Biett's collar which is an indicator of palmoplantar syphilis was seen only in 45.5% of the cases. Conclusion The clinicians must be aware that palmoplantar skin lesions might be the only clinical presentation of syphilis and a high index of suspicion is needed to correctly diagnose and treat the condition in such a setting.

Involvement of palms and soles in patients with autoimmune bullous diseases: a comparative analysis of a diagnostically relevant localization.

The involvement of palms and soles is variable among disease entities belonging to autoimmune bullous diseases (AIBD). We present our own clinical-laboratory experience concerning presentations of skin lesions on palms and soles in the pemphigus diseases group, pemphigoid diseases group, epidermolysis bullosa acquisita (EBA), and lichen planus pemphigoides (LPP) and discuss the pertinent literature. Lesions on palms and soles were assessed retrospectively on the basis of just photographic archives from the beginning of 2014 to March 2023. We comparatively evaluated 462 Slavic patients with AIBD. Palmoplantar involvement was observed in only 21 patients with AIBD (12 females and 9 males). There was no statistically significant difference between palmoplantar involvement in the pemphigus diseases group compared to the pemphigoid diseases group and no statistically significant difference between the pemphigus diseases group compared to the subepithelial AIBD. Nevertheless, particularly in LPP and EBA, and occasionally in pemphigus diseases and pemphigoid diseases groups of AIBD, localization on palms and soles may be diagnostically important at the clinical level.

CPC03 Triad of generalized rash, peripheral eosinophilia and coexisting obstructive airway disease

Abstract An 87-year-old woman was referred to the acute dermatology service with a 1-week history of a generalized painful rash. She was under the care of the medical team for treatment of pneumonia with symptoms of a cough, fevers and shortness of breath. Her past medical history included adult-onset asthma, hyponatraemia and hypertension. She had never smoked. On examination, she had erythematous smooth papules and plaques on her limbs and torso with palmoplantar involvement, alongside purple macules and patches where older lesions were present. There was no lymphadenopathy and no mucosal involvement. She had an oxygen requirement of 2 L per minute via nasal cannula. Initial blood tests showed eosinophils of 2.8 × 109 cells L−1 and a C-reactive protein (CRP) of 77 mg L−1. A chest radiograph showed bilateral ill-defined shadowing. Two skin punch biopsies were performed for histology and immunofluorescence. Vasculitis screen identified positive antinuclear antibodies (anti-Ro) and reduced complement C4 with negative antineutrophil cytoplasmic antibody (ANCA). The patient remained unwell with increasing CRP and peripheral eosinophilia (up to 9.2 × 109 cells L−1) with rash progressing to exhibit a reticular pattern. Alongside bilateral patchy ground glass opacification on chest computed tomography, a clinical diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA) was made. Differential diagnoses included viral exanthem, erythema multiforme and urticarial vasculitis. Screening for cardiac, renal and sinus involvement was undertaken. The patient improved clinically following the initiation of systemic steroids and the peripheral eosinophilia returned to baseline. Skin histology reinforced the clinical diagnosis of EGPA, demonstrating a dermal and perivascular eosinophilic infiltrate with focal extension into vessel walls. EGPA is a rare small- to medium-sized vessel vasculitis with an annual incidence of 0.9–2.4 per million and a median age at diagnosis of 49–59 years. The clinicopathological hallmarks, as in this case, are asthma with peripheral eosinophilia and pulmonary eosinophilic infiltrates. Median time from onset of asthma to presentation with EGPA is 5–9 years. EGPA remains a clinical diagnosis, reinforced by serological and histological findings, although ANCA is reported to be negative in 60–70% of cases. Systemic steroids are the first-line therapy, with a role for second-line immunosuppressants such as methotrexate and rituximab. The key learning points from this case are to keep an open mind in considering a systemic cause for cutaneous manifestations, especially when the patient does not fulfil the usual demographic picture.

Pediatric Psoriasis: Clinical Aspects and Comorbidities: A Study of 50 Patients in Morocco

Aims: The objective of our study was to describe the epidemiological and clinical characteristics of pediatric psoriasis, as well as metabolic comorbidities and cardiovascular diseases.&#x0D; Study Design: Retrospective descriptive study.&#x0D; Place and Duration of Study: Dermatology department of the CHU of Rabat Morocco over a two- and half-year period.&#x0D; Methodology: We conducted a retrospective descriptive study collecting the cases of psoriasis in children followed in the pediatric dermatology consultation of Ibn Sina University Hospital of Rabat Morocco over a two- and half-year period.&#x0D; Results: We collected 50 patients. A female predominance was notedwith a sex ratio of 0.58. Concerning the antecedents; Parental consanguinity was identified in 8 % of cases, family history of psoriasis in only 6% and the atopy in 16%. The triggering factors were an infection in 12% of cases and psychological trauma in 6 % of cases. Concerning the metabolic comorbidity, one case of diabetes (2%), one case of obesity (2%) and three cases of overweight (6%) were noted. however, no cases of dyslipidaemia were reported.Psoriasis vulgaris was the most frequent clinical presentation (48 %), followed by guttate psoriasis (34%), inverted psoriasis (10%), napkin psoriasis (4 %) and blaskoline psoriasis (2 %). Palmoplantar involvement was observed in 10 % of cases, nail involvement in 22% and scalp involvement in 40 %. Oral mucosal involvement was noted in only one patient.

Effectiveness of risankizumab in the treatment of palmoplantar psoriasis: a 52-week Italian real-life experience.

Data on the treatment of palmoplantar psoriasis (PP) are scarce, representing a therapeutic challenge. This study aims to assess the efficacy and safety of risankizumab in a population of patients with psoriasis with a palmoplantar involvement, over a 52-week treatment period. We performed a retrospective analysis in a cohort of patients with PP, with or without involvement of other skin sites. Palmoplantar Psoriasis Area and Severity Index (ppPASI) was assessed at baseline and after 4, 16, 28 and 52 weeks, to evaluate the PP severity. Sixteen patients were enrolled. The rates of ppPASI90 responses constantly increased during the period of observation and were 18.7%, 62.2%, 75.0% and 81.2% at weeks 4, 16, 28 and 52, respectively. Only two patients suspended treatment because of ineffectiveness at week 16. Our data from a series of 16 patients reveal that risankizumab could represent an effective and safe therapeutic choice in patients with PP.

PALMOPLANTAR LICHEN SCLEROSUS ET ATROPHICUS : A CASE REPORT

Introduction: Lichen sclerosus et atrophicus mainly affects the genital area. The palmo-plantar involvement is most often part of a diffuse cutaneous involvement, which is rarely exclusive. We report a case of acral lichen sclerosus et atrophicus, without any other involvement. Case Report: A 58-year-old man presented with lesions of the hands and feet, consisting of subungual hyperkeratosis and squamo-keratoticperi-onyxis of the toenails, sclero-atrophic ivorine plaques with depressed keratoticmicropapules on the soles and palm hollows, extending to the lateral and dorsal surfaces, with involvement of the interdigital and inter-toe spaces. There was no other cutaneous or genital involvement. Histological examination showed a lichen sclerosus et atrophicus appearance. Discussion: A few cases of lichen sclerosus et atrophicus limited exclusively to the feet and/or hands have been reported, affecting either the palmoplantar or dorsal surface, with or without ungual involvement. No case of lichen sclerosus et atrophicus affecting only the feet and hands on both surfaces with onychodystrophy, as in our case, has been reported.

Coexistence of psoriasiform stratum corneum and underlying lichenoid features in skin biopsies of cutaneous reactions to anti-PD1.

Coexistence of psoriasiform stratum corneum and underlying lichenoid features in skin biopsies of cutaneous reactions to anti-PD1.

Predicting the Risk of Nail Involvement in Psoriasis Patients: Development and Assessment of a Predictive Nomogram

Nail involvement has a tremendous impact on psoriasis patients. Early detection and prompt intervention of psoriatic nail damage are necessary. A total of 4290 patients confirmed to have psoriasis between June 2020 and September 2021 were recruited from the Follow-up Study of Psoriasis database. Among them, 3920 patients were selected and divided into the nail involvement group (n = 929) and the non-nail involvement group (n = 2991) by inclusion and exclusion criteria. Univariate and multivariable logistic regression analyses were performed to identify the predictors of nail involvement for the nomogram. Calibration plots, the receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the discriminative and calibrating ability and clinical utility of the nomogram. Sex, age at onset, duration, smoking, drug allergy history, comorbidity, sub-type of psoriasis, scalp involvement, palmoplantar involvement, genital involvement, and PASI score were selected to establish the nomogram for nail involvement. AUROC (0.745; 95% CI: 0.725-0.765) indicated the satisfactory discriminative ability of the nomogram. The calibration curve showed favorable consistency, and the DCA showed the good clinical utility of the nomogram. A predictive nomogram with good clinical utility was developed to assist clinicians in evaluating the risk of nail involvement in psoriasis patients.

Effectiveness of Brodalumab on Scalp, Palmoplantar, and Genital Psoriasis: A Descriptive Pilot Study

Introduction. Psoriasis of the scalp, genital areas, and palms and soles represents a treatment challenge in clinical practice. Randomized clinical trials and real‐life studies investigating the efficacy of biological drugs in these sites are scarce. The present is a descriptive retrospective real‐life study with the aim to evaluate the efficacy and safety of brodalumab in these difficult‐to‐treat areas. Materials and Methods. 158 psoriatic patients with scalp involvement, 69 with genital involvement, and 54 with palmoplantar involvement being treated with brodalumab were assessed at weeks 16, 28, and 48 using PSSI (Psoriasis Scalp Severity Index), sPGA‐G (Physician Global Assessment of Genitalia), and ppPASI (Palmoplantar Psoriasis Area and Severity Index). Results. The achievement of relative PSSIs (75%, 90%, and 100%) was already observed in week 16. 86% achieved PSSI75, 80% PSSI90, and 75% PSSI100. The sPGA‐g 0/1 was achieved by 83% of patients at week 16 and 100% at week 24 and 48. At week 16 ppPASI75, 90, and 100 were all reached by 76.9% of patients; at week 24, 84.6% of patients reached all relative ppPASI. Conclusions. Brodalumab proved to be effective and safe in the treatment of scalp, genital, and palmoplantar regions.