{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:32:26Z","timestamp":1780680746205,"version":"3.54.1"},"reference-count":44,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T00:00:00Z","timestamp":1585526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Palmoplantar pustulosis (<jats:styled-content style=\"fixed-case\">PPP<\/jats:styled-content>) and acrodermatitis continua of Hallopeau (<jats:styled-content style=\"fixed-case\">ACH<\/jats:styled-content>) are rare variants of psoriasis. Knowledge of the efficacy of biologics is scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the real\u2010life efficacy of tumour necrosis factor blockers and ustekinumab in <jats:styled-content style=\"fixed-case\">PPP<\/jats:styled-content> and in <jats:styled-content style=\"fixed-case\">ACH<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicentre retrospective descriptive study was conducted in 19 dermatology departments, including all patients with <jats:styled-content style=\"fixed-case\">PPP<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">ACH<\/jats:styled-content> seen from 2014 to 2016 who received one of the studied biologics. The data were collected by a standardized document. Factors associated with complete clearance (<jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>) were analysed by multivariate analysis, estimating odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s) and 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 92 patients included, 50 received adalimumab, 44 ustekinumab, 36 etanercept and 31 infliximab. Improvement and <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> were observed in 83.9% and 20.0% patients receiving infliximab, 75.0% and 38.6% ustekinumab, 57.1% and 20.0% etanercept and 60.4% and 29.2% adalimumab. We found no significant difference in <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> rates or duration of treatment among the biological treatments (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.18 and <jats:italic>P<\/jats:italic>\u00a0=\u00a00.10, respectively). On multivariate analysis, <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> with etanercept was associated with the <jats:styled-content style=\"fixed-case\">ACH<\/jats:styled-content> form and not smoking [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a09.5 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.1\u201382.7), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04 and 0.1 (0.01\u20130.9), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04]; with ustekinumab, male sex and absence of obesity [6.0 (1.3\u201328.6), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02 and 4.7 (1.0\u201322.7), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.05]; with adalimumab, the <jats:styled-content style=\"fixed-case\">ACH<\/jats:styled-content> form [11.9 (2.7\u201352.3), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001]; and with infliximab, obesity [5.6 (1.1\u201329.4), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found no difference in efficacy between <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> blockers and ustekinumab and among the three different <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> blockers in real life for <jats:styled-content style=\"fixed-case\">PPP<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">ACH<\/jats:styled-content>, which reveals the heterogeneity of clinical response to biologics in pustular psoriasis as compared with plaque psoriasis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.16265","type":"journal-article","created":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T06:23:34Z","timestamp":1581056614000},"page":"2330-2338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Efficacy and safety of 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