Deucravacitinib for the Treatment of Palmoplantar Pustulosis

Eligibility Criteria

• * • Adults aged 18 years of age and older
• * Dermatologist confirmed diagnosis of PPP for at least 6 months
• * Moderate-severe PPP, defined as a ppPASI \> 12
• * Inadequate response to topical therapy and a candidate for systemic or phototherapy
• * Willing to discontinue current topical and/or systemic PPP treatments, except for OTC emollients
• * • Participants with other immune-mediated conditions requiring concurrent systemic immunosuppressant treatments
• * Current/recent administration of PPP-specific medications including:
• * Rituximab within 6 months of the baseline visit
• * Biologics within 12 weeks of baseline visit
• * Systemic steroids, oral immunosuppressants (azathioprine, cyclosporine, methotrexate, mycophenolate mofetil, tacrolimus), oral retinoids (acitretin, isotretinoin), apremilast, or dapsone within 4 weeks of baseline visit
• * Phototherapy within 4 weeks of baseline visit
• * Prescription topical medications (including calcineurin inhibitors, crisaborole, retinoids, steroids, tar, vitamin D analogs) within 2 weeks of baseline visit
• * History of active infection and/or febrile illness within 7 days; or infection requiring antibiotic treatment within 30 days; or serious infection requiring hospitalization and/or IV antibiotics within 90 days
• * Evidence of other infection including:
• * Active or untreated latent tuberculosis, defined as radiographic or laboratory evidence of active TB or positive quantiferon or PPD, unless the subject has completed the recommended treatment
• * Human immunodeficiency virus infection (positive HIV antibody)
• * Active hepatitis B
• * Active hepatitis C
• * Evidence of clinically significant laboratory abnormality including:
• * Absolute WBC count \< 3000/mm3
• * Platelet count \< 100,000/mm3
• * Hemoglobin \< 9.0 g/dl
• * ALT or AST \> 3 times the upper limit of normal
• * History of cancer within the past 5 years, excluding treated non-melanoma skin cancer (basal cell carcinoma, squamous cell carcinoma)
• * Other uncontrolled chronic medical condition that may interfere with a patient's ability to participate in the clinical trial
• * Major surgery within 4 weeks of baseline visit
• * Receipt of live vaccine within 8 weeks of baseline visit
• * Pregnant or breastfeeding individuals
• * Inability to comply with any of the study procedures
• * Individuals who are incarcerated or compulsory detained