Successful Treatment of Palmoplantar Psoriasis With Apremilast in an Immunosuppressed Pediatric Patient on Concurrent Biologic Therapy.

Immunosuppressive medication may be indicated in patients with severe psoriasis refractory to other treatment modalities. There is a subset of patients, however, who are immunosuppressed at baseline and are not ideal candidates for these agents. Here we report the case of a 15-year-old girl on immunosuppressive medication for preexisting pancolitis and chronic recurrent multifocal osteomyelitis who had an excellent response to concurrent apremilast therapy for her previously refractory palmoplantar psoriasis. These findings support the potential role of apremilast in treating pediatric palmoplantar psoriasis and its utility as an adjunctive therapy in immunosuppressed patients with refractory skin disease.