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Interventions for chronic palmoplantar pustulosis.

A M Marsland, R J G Chalmers, S Hollis

The Cochrane Database of Systematic Reviews

|January 27, 2006

Summary

Systemic retinoids and oral PUVA show effectiveness for palmoplantar pustulosis (PPP) treatment. Combining PUVA with retinoids offers superior results, though an ideal treatment for this chronic skin condition remains elusive.

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Area of Science:

Dermatology
Inflammatory skin diseases
Evidence-based medicine

Background:

Chronic palmoplantar pustulosis (PPP) is an inflammatory skin condition causing recurrent pustules on palms and soles.
Affected areas exhibit redness, scaling, and painful cracking.
Current treatments for PPP lack consistent, reliable effectiveness.

Purpose of the Study:

To evaluate the efficacy of various treatments for palmoplantar pustulosis (PPP).
To assess treatment effects on disease severity and remission maintenance.

Main Methods:

Systematic review of randomized controlled trials (RCTs) for PPP treatments.
Searched multiple databases (Cochrane, MEDLINE, EMBASE) and contacted trial authors.
Included 23 trials with 724 participants, assessing treatment eligibility and quality.

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Main Results:

Systemic retinoids and oral PUVA demonstrated significant improvement rates (44%).
Combination therapy of PUVA and retinoids proved more effective than individual treatments.
Topical steroids with hydrocolloid occlusion, low-dose ciclosporin, tetracyclines, and Grenz Ray Therapy may also be beneficial.

Conclusions:

While several interventions show promise, an optimal treatment for PPP is not yet established.
Standardized assessment methods are needed to accurately evaluate treatment response and patient relevance.
Improved study design and reporting are crucial for guiding clinical decisions in PPP management.