Palmoplantar psoriasis (PPP) is a disabling condition that is difficult to treat. Herein, we report a case of successful treatment of recalcitrant PPP with topical crisaborole, 2%, cream.
A woman in her 50s with a history of rheumatoid arthritis (RA) presented with a 10-year history of erythematous plaques, papules, and deep-seated pustules occurring mostly on the hypothenar eminences of the palms and weight-bearing surfaces of the plantar aspects of the feet that had been clinically diagnosed as PPP (Figure 1). The RA was managed with oral methotrexate and sulfasalazine. The lesions persisted despite initial treatment with high-potency topical corticosteroids; calcipotriene, 0.005%, cream; urea, 40%, cream; and methotrexate, 17.5 mg/wk. The patient could not make frequent trips for phototherapy.