Palmoplantar pustular lesions during ovulation inducement therapy: new insight into the pathomechanism of palmoplantar pustulosis?

these lesions improved and worsened cyclically along with buserelin acetate administration, the symptoms were relatively easily controlled with a topical steroid and no arthritis associated with SAPHO syndrome was apparent during all courses. Case 2 is that of a 34-year-old Japanese woman who presented with pustules on her palms and soles ( fig. 1 E). She noticed persistent palmar pustules and vesicles about a month after the administration of buserelin acetate. Although she had also been smoking for several years, she had never experienced palmoplantar lesions until this time. The administration protocol of buserelin acetate and an estrogen patch was the same as that in case 1. Her lesions were recalcitrant to topical steroid, topical maxacalcitol and topical PUVA treatments. The condition improved slightly after the cessation of buserelin acetate ( fig. 1 F). The parts of the skin on which estrogen patches or buserelin acetate were applied did not show any contact dermatitis or pustules and the patient did not have any personal or familial history of PPP or psoriasis just as in case 1. Signs of arthritis suggesting SAPHO syndrome did not appear during all courses.