Treatment of hand and foot psoriasis with emphasis on efalizumab

Hand and foot psoriasis is a chronic and debilitating disease that manifests as plaque-type or pustular-type lesions. Although the palms and soles represent only 2% of the total body surface area, psoriasis of these regions may lead to physical dysfunctions that can greatly impair dexterity, mobility, and the quality of life of affected individuals. Deregulation of T-lymphocyte-mediated immune response is important in the pathophysiology of psoriasis. Efalizumab (Raptiva, Genentech) is an anti-CD11a monoclonal antibody that disrupts the interaction between T cells and antigen-presenting cells, thereby inhibiting various T-cell-mediated immune processes that include activation and trafficking. Recent evidence indicates that efalizumab may be beneficial for patients with hand and foot psoriasis.