Tofacitinib Plus Imatinib in Moderate-to-Severe Palmoplantar Pustulosis

inclusion Criteria: Age ≥ 18 years at the time of screening. Diagnosis of palmoplantar pustulosis (PPP) for at least 12 weeks prior to the screening visit. May have a history of or concurrent plaque psoriasis. PPPASI score ≥ 12 at both the screening and baseline visits. PPP-IGA score ≥ 3 at both the screening and baseline visits. Presence of pustules on the palms and/or soles at both the screening and baseline visits, defined as pustule severity ≥ 2 in at least one region (one palm or one sole) based on the PPPASI. Must have a confirmed diagnosis of PPP by photographic adjudication. Male and/or female participants. Female participants must not be pregnant, not be lactating (including feeding an infant by breast pump). Exclusion Criteria: Significant improvement in PPP symptoms between the screening and baseline visits, defined as a reduction in PPPASI score of ≥ 5 units. Presence of any of the following conditions: guttate psoriasis, erythrodermic psoriasis, generalized pustular psoriasis, acrodermatitis continua of Hallopeau, atopic dermatitis, dyshidrotic eczema, chronic hand eczema, or folliculitis. Drug-induced psoriasis (e.g., first onset or current flare triggered by beta-blockers, calcium channel inhibitors, lithium preparations, or TNF inhibitors) or drug-induced pustular psoriasis (e.g., acute generalized exanthematous pustulosis, acute localized exanthematous pustulosis). Active infection or history of infection, as follows: Any active infection withi…