Table 1.

Description of cases

Case	1	2	3	4	5
Sex	Male	Male	Female	Female	Male
Age	37	42	67	30	41
Disease duration (years)	17	28	30	Unknown	15
Psoriasis type	Plaque	Plaque	Plaque	Plaque	Plaque
Prior pustular psoriasis	No	No	No	No	No
Psoriatic arthritis	Yes	No	No	No	Yes
Familiy history of psoriasis	Negative	Positive	Negative	Unknown	Negative
Prior UV-therapy	Yes	Yes	Yes	Yes	Yes
Prior systemic therapies	Methotrexate Leflunomide Etanercept Prednisolone	Fumaric acid esters Cyclosporine	Fumaric acid esters	Fumaric acid esters Cyclosporine Retinoids Methotrexate	Fumaric acid esters Cyclosporine Methotrexate
Initial response to infliximab	Excellentc	PASI 75f	PASI 75	PASI 75	PASI 75
Time of manifestation of PPP	Week 38d	8 weeks after end of infliximab treatment	Week 3d	Week 22d	Week 40d
Concomitant worsening of plaque psoriasisa	Yes	Yes	No	No	Yes
Development of GPP in addition to PPP	Yes	No	No	No	No
Potential trigger factors of PPP
Infection prior to PPP	Yes	No	Yes	No	No
Present smoking	No	No	Yes (36 packyears)	Unknown	Unknown
Discontinuation of infliximab	Yes	Yes	Yes	No	Yes
Systemic therapy with sufficient control of PV and PPPb	Adalimumab 40 mg e.o.w	Etanercept 25 mg BIW plus methotrexate 7.5 mg/week orally	PUVA-therapy of palms and soles	(Additional topical therapy)	Etanercept 50 mg BIW
Systemic therapy that failed to control PV or PPP	Etanercept 50 mg BIWe plus methotrexate 15 mg/week orally				Etanercept 25 mg BIW

PPP Pustulosis palmoplantaris, GPP Generalized pustular psoriasis, PV Psoriasis vulgaris, e.o.w Every other week

^a Loss of >50% of maximum PASI response or increase of physician’s global assessment (PGA) by ≥ 2

^b All patients received additional topical therapy with glucocorticosteroids and Vitamin D analogues

^c Improvement rated by PGA with “almost clear” (PGA = 1)

^d Week of infliximab treatment

^e BIW = twice weekly

^f PASI 75 = Reduction in the psoriasis area and severity index (PASI) by ≥75%