Biologics as a novel treatment option for palmoplantar pustulosis: a comprehensive review

Introduction:
Palmoplantar pustulosis (PPP) is a complex inflammatory skin disease. Currently, no standardized treatments exist, and traditional systemic therapies often display limited effectiveness and substantial adverse effects. Biologics, however, have shown potential for enhanced clinical outcomes in psoriasis patients, thereby prompting this investigation into their applicability in PPP treatment.

Aim:
This study constitutes the first comprehensive review to assess the effectiveness and underlying mechanisms of biologics for PPP.

Material and methods:
We conducted a PubMed search to identify studies on biologics for PPP from 1992 onward. The review focused on assessing the efficacy of biologics targeting cytokines like IL-1, IL-8, IL-17, IL-12/23, IL-36, and TNF-a.

Results:
Biologics for PPP are generally less effective than for psoriasis. Secukinumab and guselkumab, IL-17 and IL-23 inhibitors respectively, have shown better results compared to other biologics in trials. However, the effectiveness of other biologics remains uncertain due to limited data.

Conclusions:
More research is needed to find effective treatments for PPP, and selecting the right biologic for each patient is challenging.