Palmoplantar pustulosis (PPP) has a significant impact on daily activities, including greater itch, fatigue, and pain than plaque psoriasis alone. A poster abstract at the American Academy of Dermatology Virtual Meeting Experience 2021 presented the results of real-world analysis of PPP vs plaque psoriasis from the Corrona Psoriasis Registry.

The classification of PPP as psoriasis is debated amongst some researchers as there is limited information on the natural history of the disease. Due to the lack of available information, therapeutic options for patients with PPP are limited. Treatments currently used to treat PPP were originally developed for other forms of psoriasis and are not designed to specifically target PPP.

Data from the Corona Psoriasis Registry, a prospective, multicenter, noninterventional registry, was used for this descriptive, cross-sectional study. In total, 64 patients with PPP were compared to 4894 patients with plaque psoriasis without pustules. Data gathered included sociodemographics, disease characteristics, PROs, and medication use.

Analyzing demographics, the proportion of patients with comorbidities between patients with PPP and plaque psoriasis was similar. In both populations, 14% had diabete, hypertension occurred in 41% of patients with PPP and 37% of patients with plaque psoriasis, and anxiety and/or depression occurred in 29% of patients with PPP and 26% of patients with plaque psoriasis.

As expected, due to the nature of localized pathology, patients with PPP had a lower mean BSA (5%) compared with patients with plaque psoriasis (10%). Based on BSA affected, 56.3% of PPP patients were classified as having moderate/severe disease compared 63.5% of patients with plaque psoriasis. However, when using visual analog scores (VAS) to assess disease severity, patients with PPP had a higher median and mean VAS score compared to individuals with plaque psoriasis. Patients with PPP experienced itch, fatigue, and pain more frequently than patients with plaque psoriasis.

Utilizing the Patient Global Assessment (PGA) as a PRO measure, patients with PPP reported a median impact of 43 vs a median of 30 in patients with plaque psoriasis. Additionally, the median reported percentage of impairment while working (10 vs 0) and in daily activities (30 vs 3) was greater for patients with PPP than those with plaque psoriasis.

Despite occurring less frequently and affecting a smaller population, a diagnosis of PPP has a great impact on an individual’s life. Patients with PPP experience a larger negative impact on the quality of life. This highlights the need for targeted therapies for PPP. —Audrey Amos, PharmD

Reference
Lebwohl M, Kotowsky N, Medeiros RA, et al. Greater disease burden associated with palmoplantar pustulosis versus plaque psoriasis: real-world evidence from the North American-based Corrona Psoriasis Registry. Poster presented at: American Academy of Dermatology Virtual Meeting Experience 2021; April 23-25, 2021; virtual.