Researchers recently undertook an epidemiologic study to investigate the prevalence of palmoplantar pustulosis (PPP) and co-existing plaque psoriasis.1
Palmoplantar pustulosis is characterized by recurrent sterile pustular dermatosis and erythematous plaques on the palms of the hands and soles of the feet, and often occurs alongside plaque psoriasis.2 As a result, some dermatologists actually consider the condition to be a subtype of psoriasis. This is still debated, however, due to evidence pointing towards differences between the genetic characteristics of PPP and those of plaque psoriasis.1,2,3
Although some research has connected PPP to tobacco use, cardiometabolic disease and/or autoimmune disease,4 little is known about the prevalence of palmoplantar pustulosis or the patients who suffer from the condition. The authors of the study, published in the British Journal of Dermatology in February 2019, aimed to fill this gap in research by collecting data from administrative healthcare registries and databases across the United States, Denmark and Germany.
Researchers pulled data for the U.S. cohort from the Truven Health MarketScan database; the Danish Nationwide Registries for the Danish cohort; and the nationwide data set from Statutory Health insurance for the German cohort. The authors gathered information on the sex and age of participants, which were similar across the three groups. They also used the Carlson Comorbidity Index to estimate a weighted comorbidity score between 0 and 6. Psoriatic arthritis, hypertension, diabetes, thyroid disease and inflammatory bowel disease were also identified using ICD-10 coding.
Of the total 1,435,751 patients identified through the U.S., Danish and German databases, investigators found 1,832 patients had palmoplantar pustulosis. The one-year prevalence of palmoplantar pustulosis was estimated at 0.009% in the U.S. cohort; 0.005% in the Danish cohort; and 0.08% in the German cohort. In patients with palmar-plantar pustulosis, 61.3% had co-occurring psoriasis in the U.S. cohort; 14.2% had co-occurring psoriasis in the Danish cohort; and 36.4% had co-occurring psoriasis in the German cohort.
1. Andersen, YUKI MF, et al. "Characteristics and prevalence of plaque psoriasis in patients with palmoplantar pustulosis." British Journal of Dermatology. (2019).
2. Olazagasti JM, Ma JE, Wetter DA. Clinical features, etiological factors, associated disorders , and treatment of palmoplantar pustulosis: the May Clinic experience, 1996-2013. Mayo Clin Proc. 2017;92:13151-8.
3. Asumalahti K, Ameen M, Suomela S et al. Genetic analysis of PSORS1 distinguishes guttate psoriasis and palmoplantar pustulosis. J Invest Dermatol. 2003;120:627-32.
4. Becher G, Jamieson L, Leman J. Palmoplantar pustulosis – a retrospective review of comorbid conditions. J Eur Acad Dermatol Venereol. 201;29:1854-6,