Clinical characteristics, quality of life and risk factors for severity in palmoplantar pustulosis: a cross‐sectional, multicentre study of 263 patients

Summary Background Palmoplantar pustulosis (PPP) is a rare, chronic, inflammatory skin disease characterized by sterile pustules on palmar or plantar areas. Data on PPP are scarce. Aim To investigate the clinical characteristics and risk factors for disease severity in a large cohort of Turkish pati...

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Published in:	Clinical and experimental dermatology Vol. 47; no. 1; pp. 63 - 71
Main Authors:	Sarıkaya Solak, S., Kara Polat, A., Kilic, S., Oguz Topal, İ., Saricaoglu, H., Karadag, A. S., Canpolat, F., Kartal, S. P., Deveci, B. N., Kacar, N., Polat Ekinci, A., Guner, R., Polat, M., Dogan, G., Guler Ozden, M., Bulbul Baskan, E., Ozaydin Yavuz, G., Adisen, E., Gulekon, A., Tanribilir, M. E., Yilmaz, O., Akman Karakas, A., Ozturk, P., Didar Balci, D., Gonulal, M., Yondem, H., Turel Ermertcan, A., Sendur, N., Topyildiz, H., Korkmaz, S., Alpsoy, E.
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 01-01-2022
Subjects:	Adult Arthritis Cross-Sectional Studies Female Foot Dermatoses - diagnosis Foot Dermatoses - epidemiology Hand Dermatoses - diagnosis Hand Dermatoses - epidemiology Humans Male Middle Aged Patients Prevalence Prospective Studies Psoriasis - diagnosis Psoriasis - epidemiology Psoriasis vulgaris Psoriatic arthritis Pustulosis Quality of Life Risk Factors Severity of Illness Index Skin diseases Smoking Turkey - epidemiology Turkey
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Summary:	Summary Background Palmoplantar pustulosis (PPP) is a rare, chronic, inflammatory skin disease characterized by sterile pustules on palmar or plantar areas. Data on PPP are scarce. Aim To investigate the clinical characteristics and risk factors for disease severity in a large cohort of Turkish patients with PPP. Methods We conducted a cross‐sectional, multicentre study of patients with PPP recruited from 21 tertiary centres across Turkey. Results In total, 263 patients (165 women, 98 men) were evaluated. Most patients (75.6%) were former or current smokers. The mean Palmoplantar Pustulosis Area and Severity Index (PPPASI) was 8.70 ± 8.06 and the mean Dermatology Life Quality Index (DLQI) score was 6.87 ± 6.08, and these scores were significantly correlated (r = 0.52, P < 0.001). Regression analysis showed that current smoking was significantly associated with increased PPPASI (P = 0.03). Coexisting psoriasis vulgaris (PsV) was reported by 70 (26.6%) patients. Male sex prevalence, PPP onset incidence, disease duration, DLQI, and prevalence of nail involvement and psoriatic arthritis (PsA) were significantly increased among patients with PPP with PsV. Of the 263 patients, 18 (6.8%) had paradoxical PPP induced by biologic therapy, and these patients had significantly increased mean DLQI and prevalence of PsA (r = 0.03, P = 0.001). Conclusion Our data suggest that smoking is a risk factor for both PPP development and disease severity. Patients with PPP with PsV present distinct clinical features and patients with biologic therapy‐induced paradoxical PPP have reduced quality of life and are more likely to have PsA.
Bibliography:	Correction added on 22 September 2021 after first online publication: The affiliations have been renumbered to match the correct author Conflicts of interest: SSS has received speaking or consulting fees from Novartis and AbbVie outside the submitted work. NK has received lecture fees from UCB, Janssen, Lilly, AbbVie and Novartis outside the submitted work. APE has received lecture fees from Novartis, AbbVie, Lilly, Jansen and Pfizer outside the submitted work. DDB has received lecture fees from UCB, Janssen, Lilly, AbbVie and Novartis outside the submitted work. EA has received speaking or consulting fees from AbbVie, Lilly and Novartis outside the submitted work. No other disclosures were received. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0307-6938 1365-2230
DOI:	10.1111/ced.14829