An institution-based non-randomised prospective study to estimate the efficacy and adverse effect profile of apremilast for moderate to severe refractory palmoplantar psoriasis

Background: Psoriasis is an immune-mediated inflammatory papulo-squamous disorder presenting as chronic plaque, pustular, erythrodermic, nail, scalp, drug induced, inverse, guttate etc. Palmoplantar psoriasis causes significant functional, cosmetic and psychological disability. Apremilast a relatively newer being PDE-4 inhibitor, having negligible adverse effects with minimum blood monitoring. Methods: It institution-based, non-randomised, prospective study conducted over period of 3 months. 42 patients moderate to severe disease (assessed using PPPASI), refractory conventional line therapy (for atleast months) or had contraindications for the same were selected from our Dermatology OPD. Follow up was done monthly 6 Results: 42% good responders. 1 patient did not respond 2 progression disease. There decrease in mean DLQI baseline 25 less than 15 by end 1st month around 5 6th month.60% showed onset response month. 45% effects, mostly nausea followed dizziness. Conclusions: From those existing literature, it can be inferred that apremilast promising palmoplantar well other forms psoriasis, especially comorbidities treatment psoriasis.