Refractory Palmoplantar Pustular Psoriasis Treated With High

Palmoplantar pustular psoriasis (PPPP) is a form of psoriasis that can be difficult to treat. We describe a case of PPPP in a patient who failed multiple therapies, including ustekinumab. The patient subsequently developed inflammatory bowel disease (IBD), and restarting ustekinumab, with inflammatory bowel disease loading doses and optimization, resulted in complete resolution of her PPPP. This success occurred after she developed tachyphylaxis against the usual dosing of ustekinumab, demonstrating a recapture of the treatment response