Cochrane · systematic review · CD011628
Interventions for chronic palmoplantar pustulosis
Obeid, G, Do, G, Kirby, L, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SkinAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
84
current version
GRADE rated
25
No studies
59
Included studies
NR
No studies 59 · 70.2%Ungraded 0 · 0%Very low 15 · 17.9%Low 4 · 4.8%Moderate 6 · 7.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Triamcinolone acetonide 0.1% cream with occlusive dressing compared to clobetasol cream 0.05% cream for chronic palmoplantar pustulosis
Population: for chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared ‐ Triamcinolone acetonide 0.1% cream with occlusive dressing vs clobetasol cream 0.05% cream | RR 1.2 [0.72, 2] | 1 study · 19 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported Triamcinolone acetonide 0.1% cream with occlusive dressing vs clobetasol cream 0.05% cream | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Triamcinolone acetonide 0.1% cream with occlusive dressing vs clobetasol cream 0.05% cream | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity ‐ not reported Triamcinolone acetonide 0.1% cream with occlusive dressing vs clobetasol cream 0.05% cream | no estimate extracted | NR | No studies |
Proportion of participants without relapse in the long term ‐ not reported Triamcinolone acetonide 0.1% cream with occlusive dressing vs clobetasol cream 0.05% cream | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects ‐ measured over 8 weeks Triamcinolone acetonide 0.1% cream with occlusive dressing vs clobetasol cream 0.05% cream | no estimate extracted | 1 study · 19 participants | Very low Downgraded: risk of bias, imprecision |
Ease of compliance to an intervention or a treatment ‐ not reported Triamcinolone acetonide 0.1% cream with occlusive dressing vs clobetasol cream 0.05% cream | no estimate extracted | NR | No studies |
Topical vitamin D derivative compared to placebo for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared in the short term (8 weeks) Topical vitamin D derivative vs placebo | RR 7.83 [1.85, 33.12] | 1 study · 188 participants | Low Downgraded: risk of bias, imprecision |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported Topical vitamin D derivative vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Topical vitamin D derivative vs placebo | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity ‐ not reported Topical vitamin D derivative vs placebo | no estimate extracted | NR | No studies |
Proportion of participants without relapse in the long term ‐ not reported Topical vitamin D derivative vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects ‐ measured over 8 weeks Topical vitamin D derivative vs placebo | RR 0.87 [0.64, 1.19] | 1 study · 188 participants | Moderate Downgraded: risk of bias, imprecision |
Ease of compliance to an intervention or a treatment ‐ not reported Topical vitamin D derivative vs placebo | no estimate extracted | NR | No studies |
Puvatherapy compared to placebo or no treatment for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared at 8 weeks Puvatherapy vs placebo or no treatment | no estimate extracted | 2 studies · 22 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported Puvatherapy vs placebo or no treatment | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Puvatherapy vs placebo or no treatment | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity at 8 weeks Puvatherapy vs placebo or no treatment | no estimate extracted | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Proportion of participants without relapse in the long term ‐ not reported Puvatherapy vs placebo or no treatment | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects ‐ measured over 8 weeks Puvatherapy vs placebo or no treatment | no estimate extracted | 2 studies · 22 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Ease of compliance to an intervention or a treatment ‐ not reported Puvatherapy vs placebo or no treatment | no estimate extracted | NR | No studies |
UVA1 compared to narrowband UVB for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared at 10 weeks UVA1 vs narrowband UVB | no estimate extracted | 1 study · 33 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported UVA1 vs narrowband UVB | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported UVA1 vs narrowband UVB | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity ‐ not reported UVA1 vs narrowband UVB | no estimate extracted | NR | No studies |
Proportion of participants without relapse in the long term ‐ not reported UVA1 vs narrowband UVB | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects measured over 10 weeks UVA1 vs narrowband UVB | no estimate extracted | 1 study · 33 participants | Very low Downgraded: risk of bias, imprecision |
Ease of compliance to an intervention or a treatment ‐ not reported UVA1 vs narrowband UVB | no estimate extracted | NR | No studies |
Etretinate compared to placebo or no treatment for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared in the short term (10 weeks or 4 months) Etretinate vs placebo or no treatment | RR 3.48 [0.82, 14.8] | 2 studies · 40 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported Etretinate vs placebo or no treatment | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Etretinate vs placebo or no treatment | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity ‐ not reported Etretinate vs placebo or no treatment | no estimate extracted | NR | No studies |
Proportion of participants without relapse in the long term (6 months) Etretinate vs placebo or no treatment | RR 2.39 [0.92, 6.17] | 1 study · 26 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of participants with adverse effects ‐ measured over 12 weeks Etretinate vs placebo or no treatment | RR 3.5 [0.95, 12.9] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Ease of compliance to an intervention or a treatment ‐ not reported Etretinate vs placebo or no treatment | no estimate extracted | NR | No studies |
Etretinate with PUVA therapy as co‐intervention compared to placebo with PUVA therapy as co‐intervention for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared in the short term (20 weeks) Etretinate with PUVA therapy as co‐intervention vs placebo with PUVA therapy | RR 1.91 [1.04, 3.5] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported Etretinate with PUVA therapy as co‐intervention vs placebo with PUVA therapy | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Etretinate with PUVA therapy as co‐intervention vs placebo with PUVA therapy | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity ‐ not reported Etretinate with PUVA therapy as co‐intervention vs placebo with PUVA therapy | no estimate extracted | NR | No studies |
Proportion of participants without relapse in the long term ‐ not reported Etretinate with PUVA therapy as co‐intervention vs placebo with PUVA therapy | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects ‐ measured over 20 weeks Etretinate with PUVA therapy as co‐intervention vs placebo with PUVA therapy | RR 17 [1.11, 259.87] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Ease of compliance to an intervention or a treatment ‐ not reported Etretinate with PUVA therapy as co‐intervention vs placebo with PUVA therapy | no estimate extracted | NR | No studies |
Etretinate compared to PUVA therapy for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared in the short term (12 weeks) Etretinate vs PUVA therapy | RR 11.2 [4.16, 30.18] | 1 study · 84 participants | Very low Downgraded: risk of bias, imprecision |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported Etretinate vs PUVA therapy | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Etretinate vs PUVA therapy | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity ‐ not reported Etretinate vs PUVA therapy | no estimate extracted | NR | No studies |
Proportion of participants without relapse in the long term ‐ not reported Etretinate vs PUVA therapy | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects ‐ measured over 12 weeks Etretinate vs PUVA therapy | RR 11.54 [5.17, 25.74] | 1 study · 84 participants | Very low Downgraded: risk of bias, imprecision |
Ease of compliance to an intervention or a treatment ‐ not reported Etretinate vs PUVA therapy | no estimate extracted | NR | No studies |
Alitretinoin compared to placebo for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared ‐ not reported Alitretinoin vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported Alitretinoin vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Alitretinoin vs placebo | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity in the long term (24 weeks) Alitretinoin vs placebo | RR 0.69 [0.36, 1.3] | 1 study · 33 participants | Moderate Downgraded: imprecision |
Proportion of participants without relapse in the long term ‐ not reported Alitretinoin vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects ‐ measured over 24 weeks Alitretinoin vs placebo | RR 0.84 [0.61, 1.17] | 1 study · 33 participants | Moderate Downgraded: imprecision |
Ease of compliance to an intervention or a treatment ‐ not reported Alitretinoin vs placebo | no estimate extracted | NR | No studies |
Etanercept compared to placebo for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared in the short term (3 months) Etanercept vs placebo | RR 1.64 [0.08, 34.28] | 1 study · 15 participants | Low Downgraded: imprecision |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported Etanercept vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Etanercept vs placebo | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity ‐ not reported Etanercept vs placebo | no estimate extracted | NR | No studies |
Proportion of participants without relapse in the long term ‐ not reported Etanercept vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects ‐ not reported Etanercept vs placebo | no estimate extracted | NR | No studies |
Ease of compliance to an intervention or a treatment ‐ not reported Etanercept vs placebo | no estimate extracted | NR | No studies |
Ustekinumab compared to placebo for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared ‐ not reported Ustekinumab vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal ‐ not reported Ustekinumab vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Ustekinumab vs placebo | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity in the short term (16 weeks) Ustekinumab vs placebo | RR 0.48 [0.11, 2.13] | 1 study · 33 participants | Low Downgraded: risk of bias, imprecision |
Proportion of participants without relapse in the long term ‐ not reported Ustekinumab vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects ‐ not reported Ustekinumab vs placebo | no estimate extracted | NR | No studies |
Ease of compliance to an intervention or a treatment ‐ not reported Ustekinumab vs placebo | no estimate extracted | NR | No studies |
Guselkumab compared to placebo for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost cleared Guselkumab vs placebo | RR 1.17 [0.15, 9.3] | 2 studies · 154 participants | Very low Downgraded: imprecision |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal Guselkumab vs placebo | RR 2.88 [0.32, 25.8] | 1 study · 49 participants | Low Downgraded: imprecision, inconsistency |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Guselkumab vs placebo | no estimate extracted | NR | No studies |
Proportion of participants achieving a 50% reduction in disease severity Guselkumab vs placebo | RR 2.88 [1.24, 6.69] | 1 study · 49 participants | Moderate Downgraded: imprecision, inconsistency |
Proportion of participants without relapse in the long term ‐ not reported Guselkumab vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects ‐ not reported Guselkumab vs placebo | no estimate extracted | NR | No studies |
Ease of compliance to an intervention or a treatment ‐ not reported Guselkumab vs placebo | no estimate extracted | NR | No studies |
Secukinumab compared to placebo for chronic palmoplantar pustulosis
Population: chronic palmoplantar pustulosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of participants cleared or almost clear ‐ not reported Secukinumab vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects serious or severe enough to have caused withdrawal Secukinumab vs placebo | RR 3.29 [1.4, 7.75] | 1 study · 157 participants | Moderate Downgraded: imprecision |
Proportion of participants with at least 50% improvement in their quality of life ‐ not reported Secukinumab vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with a 50% reduction in disease severity Secukinumab vs placebo | RR 1.55 [1.02, 2.35] | 1 study · 157 participants | Moderate Downgraded: imprecision |
Proportion of participants without relapse in the long term ‐ not reported Secukinumab vs placebo | no estimate extracted | NR | No studies |
Proportion of participants with adverse effects in the short term ‐ not reported Secukinumab vs placebo | no estimate extracted | NR | No studies |
Ease of compliance to an intervention or a treatment ‐ not reported Secukinumab vs placebo | no estimate extracted | NR | No studies |