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Case Reports
. 2025 Sep 22:18:11795441251378521.
doi: 10.1177/11795441251378521. eCollection 2025.

Relapsing Polychondritis With Palmoplantar Pustulosis: A Case Report

Lainis Vasileios  1 , Katsouli Olga  1 , Vlachoyiannopoulos G Panayiotis  1
Affiliations
Case Reports

Relapsing Polychondritis With Palmoplantar Pustulosis: A Case Report

Lainis Vasileios et al. Clin Med Insights Arthritis Musculoskelet Disord. .

Abstract

Relapsing polychondritis (RP) is a rare autoimmune disease that affects cartilaginous tissues and proteoglycan-rich organs. Around 30% of cases have coexisting autoimmune inflammatory diseases. Palmoplantar pustulosis (PPP) is extremely uncommon in RP. We report a case of resistant RP, complicated with PPP. A 36-year-old female presented with fever, nose and earlobe chondritis, and symmetric arthritis. Infectious and connective tissue diseases were ruled out. The RP diagnosis was made, and she was treated with corticosteroids and methotrexate. Three years later, she experienced acute dyspnea due to tracheobronchial chondritis, and she was placed on induction treatment with 6 cyclophosphamide pulses, accompanied by maintenance therapy with mycophenolate mofetil (MMF). After 4 years, she presented with scleritis and panuveitis. The MMF was discontinued, and she was treated with tocilizumab (TCZ) 162 mg/week. Four months after the initiation of TCZ, the patient experienced erythematous papules and pustules on both palms and soles, suggestive of PPP. She received oral corticosteroids in addition to TCZ, with complete regression of symptoms.

Keywords: biologics; case report; palmoplantar pustulosis; relapsing polychondritis; tocilizumab.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

The right eye of a person with brown hair, who is using a yellow thumb to assist their eye, displaying red nasal discharge and bloodshot appearance.
Figure 1.
Left eye showing nasal conjunctival and episcleral injection.
Before and after palmar pustulosis treated with corticosteroids
Figure 2.
Palmar pustulosis before and after treatment with oral corticosteroids.
See this image and copyright information in PMC

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