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Antibacterial Treatment of Palmoplantar Pustulosis Shortens Hortens the Response Time and the Lymphocyte / Monocyte Ratio can Serve as a Biomarker of Palmoplantar Pustulosis

Palmoplantar pustulosis (PPP) is a chronic in ammatory dermatosis characterized by sterile pustules on the palms and soles. To treat the symptoms, antimicrobial agents such as tetracyclines, macrolides, and cephalosporins are effective for PPP due to their anti-in ammatory effects. To date, there have been no reports on the response rates and time to response of the antibiotics and biomarkers to indicate the severity of PPP. In this study, we retrospectively investigated responsiveness against PPP and possible biomarkers from laboratory test data. During the 5-year study period, 65 PPP patients who visited Asahikawa Medical University Hospital were classi ed into two groups: non-responders (n = 22) and responders (n = 43). We compared patient background, PPP drugs and laboratory test values between the two groups. Among PPP drugs, the proportion of patients who received antimicrobial agents in the responder group was signi cantly higher than that in the non-responder group. Among the responder group with antimicrobial agents, the time to response was signi cantly shorter than that of the responder group without antimicrobial agents. In laboratory values, the changes in the levels of lymphocyte to monocyte ratio (LMR), total protein (TP), and albumin (ALB) in the responder group were signi cantly decreased compared with those in the non-responder group. These results suggest that antimicrobial agents contribute to the early symptomatic improvement of PPP and shortened the time to response. The reductions in LMR were observed with PPP improvement during the antimicrobial therapy, therefore, this laboratory item has the potential to serve as a biomarker for PPP.