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The Cutting Edge
November 2009

Leflunomide in the Treatment of Palmoplantar Pustulosis

Author Affiliations




Arch Dermatol. 2009;145(11):1224-1226. doi:10.1001/archdermatol.2009.256

Palmoplantar pustulosis (PPP) is a chronic inflammatory disease characterized by recurrent pustules on the palms and soles. Its etiology is unknown, and its relationship to psoriasis is not clear. Treatment of PPP can be challenging. Several immunomodulatory drugs have been used with moderate results. Herein, we report 2 cases of PPP that achieved complete remission with leflunomide.

In 1995, a 30-year-old woman presented with a 6-day history of fever and pruritic pustules on her left hand. Physical examination revealed confluent pustules surrounded by erythema on the dorsal aspect of the left hand, palm, and wrist (Figure 1). There were no lesions in other locations. Her medical history was otherwise unremarkable.