Deucravacitinib for the Treatment of Palmoplantar Pustulosis

Inclusion 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 Exclusion Criteria: * • 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 pos…