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J Dermatol Sci. 2017 Jan;85(1):20-26. doi: 10.1016/j.jdermsci.2016.09.019. Epub 2016 Sep 29.

Palmoplantar pustular psoriasis (PPPP) is characterized by activation of the IL-17A pathway.

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Innovaderm Research, 1851 Sherbrooke St. East, Suite 502, Montreal, Quebec, H2K 4L5, Canada. Electronic address:
Laboratory of Investigative Dermatology, The Rockefeller University, 1230 York Avenue, New York, NY, 10065 USA.
Immunoregulation Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montreal, Quebec, H2X 0A9, Canada.
Dept. of Population Health Science and Policy, Dept. of Genetics and Genomics Science and Dept. of Dermatology, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave, L2-70C, Box 1077, New York, NY, 10029, USA.
Innovaderm Research, 1851 Sherbrooke St. East, Suite 502, Montreal, Quebec, H2K 4L5, Canada.



Palmoplantar pustular psoriasis (PPPP) is a variant of psoriasis, which has significant negative impact on quality of life. The cellular and molecular inflammatory pathways involved in PPPP have not been well studied.


Study the expression of cytokines and chemokines involved in the IL-17/IL-23 axis in palmoplantar pustular psoriasis and other difficult to treat psoriasis areas (palms, scalp, elbows and lower legs).


Skin biopsies were performed on a total of 80 patients with PPPP, non-pustular palmoplantar psoriasis (NPPPP), or psoriasis located on elbows, knees and scalp as well as 10 healthy subjects. RT-PCR, immunohistochemistry and flow cytometry on cells extracted from skin biopsies were used to compare PPPP to other forms of psoriasis.


There was a significant (p<0.05) increase in the expression of IL-1β, IL-6, LL-37, IL-19, IL-17A, CXCL1 and CXCL2 in PPPP as compared to NPPPP. However, there was no significant difference in expression of IL-23 in PPPP as compared to NPPPP and other forms of psoriasis. The proportion of IL-22+ but not IL-17A+ mast cells was higher in PPPP as compared to NPPPP (p<0.05).


These results suggest that the IL-17A pathway may play a more important role in PPPP than in NPPPP.


IL-17; IL-23; Palmoplantar psoriasis; Palmoplantar pustular psoriasis; Psoriasis; Skin biopsies

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