Abstract
Background:
Psoriasis is a chronic inflammatory disease that affects skin and joints and is associated with numerous comorbidities. There are several clinical subtypes including the uncommon pustular variants, which are subdivided into generalized and localized forms. Palmoplantar pustulosis is considered a subtype of pustular psoriasis that manifests as localized eruptions of pustules affecting the palms and/or soles. The disease often persists for several years or decades, with frequent periods of exacerbation and partial remissions and may significantly impair quality of life secondary to pain, pruritus and resulting functional disability.
Case Description:
This case report documents a 54-year-old woman who presented with a painful pustular lesion on her right palm. Careful patient history and biopsy of the lesion confirmed palmoplantar pustulosis. Initial treatment with clobetasol propionate 0.25% cream resulted in no improvement so she was switched to halobetasol propionate 0.01% and tazarotene 0.045% lotion—a novel corticosteroid–retinoid combination, while awaiting payor approval for systemic biologic therapy. Within a week, the pustular lesions and pain had resolved and her quality of life was significantly improved, so the patient elected to continue with topical therapy. This improvement was maintained at 6-week follow-up and during a 2-week reduced dose treatment schedule. She reflared 5 weeks after stopping treatment, but cleared again after reintroduction of the therapy. No side effects or adverse events were reported during treatment.
Conclusion:
Halobetasol propionate 0.01% and tazarotene 0.045% lotion may be an effective option for treatment and maintenance in patients with palmoplantar pustulosis.
Keywords
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