{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T13:00:29Z","timestamp":1784206829333,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"unrestricted research"},{"DOI":"10.13039\/100019718","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019718","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009947","name":"Merck Sharp & Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023517","name":"Sandoz","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023517","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020975","name":"UCB Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020975","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Little is known about the clinical characteristics, diagnostic delay and treatment survival in patients with palmoplantar pustulosis (PPP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To analyse the survival rates of patients with PPP in Austria treated with phototherapy, conventional systemic therapies and biologics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective study using data from the Psoriasis Registry Austria (PsoRA). The analysis included data collected between 16 May 1997 and 11 April 2024 from patients with PPP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included data from 190 patients who underwent 397 treatments. Fifty-four per cent of patients (n = 37\/69) were initially misdiagnosed as having eczema with a mean (SD) diagnostic delay of 2.8 (4.8) years. Patients were predominantly women (n = 141\/190; 74.2%) and smoked (n = 76\/98; 78%). Patients were treated with biologics (n = 198\/397; 49.9%), phototherapy (n = 100\/397; 25.2%) and conventional systemic therapies (n = 99\/397; 24.9%). Median survival time for all treatments was 0.6\u2005years [95% confidence interval (CI) 0.5\u20130.8], with patients on ustekinumab having the longest median survival time of 2.7\u2005years (95% CI 2.3\u2013upper limit not reached), surpassing all other therapies. This superiority disappeared after interleukin (IL)-23p19 inhibitors were introduced in Austria. Compared with biologics, conventional systemic treatments [hazard ratio (HR) 2.17; P &amp;lt; 0.001] and phototherapy (HR 4.43; P &amp;lt; 0.001) were associated with a significantly higher risk of treatment discontinuation. In the overall cohort, disease durations of \u2265 2 to &amp;lt; 10\u2005years (HR 0.66; P = 0.05) and \u2265 10\u2005years (HR 0.59; P = 0.004) significantly reduced the risk of treatment discontinuation, while concomitant plaque psoriasis significantly increased the risk of treatment discontinuation (HR 1.43; P = 0.05). In the biologic cohort, concomitant arthritis (HR 2.11; P = 0.002) and the presence of one comorbid disease (HR 2.34; P = 0.03) increased the risk of treatment discontinuation. Furthermore, sex, age at disease onset and smoking did not influence the risk of treatment discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that more than half of patients with PPP experience a diagnostic delay of several years due to an initial misdiagnosis. Patients on ustekinumab (IL-12\/23p40 inhibitor) had the longest treatment survival, although its superiority diminished with the introduction of IL-23p19 inhibitors. Finally, shorter disease duration and concomitant plaque psoriasis is a general risk factor for treatment discontinuation, while the presence of a comorbidity and concomitant psoriatic arthritis are risk factors for discontinuing biologics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljaf394","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T12:03:23Z","timestamp":1760097803000},"page":"77-85","source":"Crossref","is-referenced-by-count":1,"title":["Real-world evidence on palmoplantar pustulosis: patient characteristics, diagnostic challenges and predictive factors for treatment survival \u2013 a retrospective registry study"],"prefix":"10.1093","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-7776","authenticated-orcid":false,"given":"Thomas","family":"Graier","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology, Medical University of Graz , Graz 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