Palmoplantar psoriasis and palmoplantar pustulosis are chronic, inflammatory skin diseases that are often resistant to topical corticosteroids or phototherapy.

This study investigated the efficacy of apremilast versus placebo and methotrexate in palmoplantar psoriasis and palmoplantar pustulosis.

Meta-analysis of placebo-controlled RCTs investigating apremilast in palmoplantar psoriasis found apremilast to be superior to placebo in achieving clinical clearance.

Apremilast was superior to placebo in achieving clinical improvements based on palmoplantar-specific metrics in palmoplantar pustulosis.

In patients with palmoplantar psoriasis, apremilast demonstrated comparable efficacy to methotrexate, and may be a preferred oral, non-biologic, systemic agent in patients with hepatic insufficiency.