Abstract: Objective: To evaluate the clinical efficacy and safety of apremilast in patients with palmoplantar pustulosis (PPP) . Methods: The clinical data of 8 patients with moderate-to-severe PPP who received apremilast in the dermatology clinic from April 2023 to April 2024 were analyzed retrospectively. The inclusion criteria included age≥18 years, disease duration of PPP≥6 months, and PPPASI score≥15, poor response to previous systemic therapies. The efficacy was assessed through the PPPASI, NRS, PGA, and DLQI scores, while the safety was evaluated through laboratory tests. Results: Before the treatment, the patients' PPPASI, NRS, PGA, and DLQI scores were 25.50±9.35, 6.50±1.58, 3.88±0.78, and 21.13±2.85, respectively. After 16 weeks of treatment, the scores decreased to 3.25±2.97, 0.75±1.09, 1.13±0.92, and 5.63±3.28, respectively. There were significant differences of these between and after treatment (Ps<0.05). During the treatment period, there were no significant abnormalities in the laboratory indexes of the 8 patients, and no serious adverse events occurred. Conclusions: Apremilast is safe and effective in the treatment of moderate-to-severe PPP.

Key words: palmoplantar pustulosis, apremilast, PDE-4 inhibitor