Palmoplantar Pustular Psoriasis: A New Clinical Case in an ElderlyPatient

Authors

  • Mildred Dorta Tuesday Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valencia Author
  • Bocaney G Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valencia Author
  • Torres A Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valenci Author
  • Vivas Toro S Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valencia Author

DOI:

https://doi.org/10.47363/JDMRS/2025(6)171

Keywords:

Psoriasis, Pustular, Palmoplantar, Methotrexate

Abstract

Psoriasis is a systemic inflammatory disease of immunogenetic origin, the palmoplantar pustular variant, most frequently in middle-aged women. It
presents with small sterile pustules on an erythematous base on the palms of the hands and soles of the feet. These pustules do not rupture, but they
acquire a dark brown color and evolve into scales that are sometimes very painful. Treatment is based on systemic and topical therapies such as topical glucocorticoids in occlusive treatment, methotrexate, psoralens, phototherapy, retinoids, colchicine, cyclosporine, and calcipotriol. Biological treatments such as etanercept have been used in recalcitrant cases. The European Commission has granted a conditional marketing authorization for SPEVIGO® (Espesolimab) monoclonal antibody as a first-in-class treatment option for pustular psoriasis flares as it blocks the activation of the interleukin-36receptor (IL-36R). The case of a 75-year-old female patient from the state of Carabobo is presented, who started her current illness in June 2023, skin phototype IV/VI, dermatosis located on the palms characterized by erythematous violaceous plaques, hyperkeratotic with regular edges, well-defined scales on the surface. surface, with pustules, areas of Ex ulceration and fissures, painful, pruritic, causing functional limitation, of weeks of evolution,paraclinical, histopathological and imaging studies are indicated and in view of their findings, a diagnosis of palmoplantar pustular psoriasis is proposed and establishes a therapeutic plan based on methotrexate 15 mg/week, occlusive topical corticosteroids and emollient, showing satisfactory improvement 8 weeks after starting treatment.

Author Biographies

  • Mildred Dorta Tuesday, Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valencia

    Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valencia

  • Bocaney G, Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valencia

    Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valencia

  • Torres A, Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valenci

    Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City.Valenci

  • Vivas Toro S, Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valencia

    Third year Resident of the Dermatology Postgraduate Program, University of Carabobo. Dr. Enrique Tejera Hospital City. Valencia

Downloads

Published

2025-01-24

Issue

Vol. 6 No. 1 (2025): volume 6 Issue 1

Section

Articles