Economic Burden of Palmoplantar Pustulosis in Sweden: A Population-based Register Study




palmoplantar pustulosis, healthcare resource use, economic burden, healthcare register, population-based, epidemiology


The aim of this study was to estimate the economic burden of palmoplantar pustulosis, a chronic relapsing skin condition commonly occurring in combination with psoriasis vulgaris. Using data from the Swedish National Patient Register and Swedish Prescribed Drug Register for 2015, the study estimated all-cause and palmoplantar pustulosis-specific healthcare resource use (inpatient stays, physician visits and drug use) for 14,715 patients with palmoplantar pustulosis, and compared these both with matched controls from the general population and with patients with psoriasis vulgaris (without palmoplantar pustulosis). Mean annual direct costs for a patient with palmoplantar pustulosis was higher compared with costs for the general population (3,000 vs 1,700 Euro, p < 0.001). Compared with psoriasis vulgaris, more patients with palmoplantar pustulosis had inpatient stays, but fewer had physician visits and psoriasis-related drugs; the overall costs were similar. Only a small fraction of the costs of physician visits and inpatient stays for patients with palmoplantar pustulosis were attributable to specific palmoplantar pustulosis problems, indicating a clear comorbidity burden in palmoplantar pustulosis.


Download data is not yet available.


Noe MH, Wan MT, Mostaghimi A, Gelfand JM, Agnihothri R, Armstrong AW, et al. Evaluation of a case series of patients with palmoplantar pustulosis in the United States. JAMA Dermatol 2022; 158: 68-72. DOI:

Olazagasti JM, Ma JE, Wetter DA. Clinical features, etiologic factors, associated disorders, and treatment of palmoplantar pustulosis: the Mayo Clinic experience, 1996-2013. Mayo Clin Proc 2017; 92: 1351-1358. DOI:

Brunasso AMG, Massone C. Recent advances in palmoplantar pustulosis. Fac Rev 2021; 10: 62. DOI:

Andersen YMF, Augustin M, Petersen J, Hagenstrom K, Mallbris L, Burge R, et al. Characteristics and prevalence of plaque psoriasis in patients with palmoplantar pustulosis. Br J Dermatol 2019; 181: 976-982. DOI:

Brunasso AM, Puntoni M, Aberer W, Delfino C, Fancelli L, Massone C. Clinical and epidemiological comparison of patients affected by palmoplantar plaque psoriasis and palmoplantar pustulosis: a case series study. Br J Dermatol 2013; 168: 1243-1251. DOI:

Lee JY, Kang S, Park JS, Jo SJ. Prevalence of psoriasis in Korea: a population-based epidemiological study using the Korean National Health Insurance database. Ann Dermatol 2017; 29: 761-767. DOI:

Schäfer I, Rustenbach SJ, Radtke M, Augustin J, Glaeske G, Augustin M. Epidemiologie der Psoriasis in Deutschland - Auswertung von Sekundärdaten einer gesetzlichen Krankenversicherung. Gesundheitswesen 2011; 73: 308-313. DOI:

Na SJ, Jo SJ, Youn JI. Clinical study on psoriasis patients for past 30 years (1982-2012) in Seoul National University Hospital Psoriasis Clinic. J Dermatol 2013; 40: 731-735. DOI:

Yan D, Afifi L, Jeon C, Cordoro KM, Liao W. A cross-sectional study of the distribution of psoriasis subtypes in different ethno-racial groups. Dermatol Online J 2018; 24: 13030. DOI:

Kharawala S, Golembesky AK, Bohn RL, Esser D. The clinical, humanistic, and economic burden of palmoplantar pustulosis: a structured review. Expert Rev Clin Immunol 2020; 16: 253-266. DOI:

Hanna ML, Singer D, Valdecantos WC. Economic burden of generalized pustular psoriasis and palmoplantar pustulosis in the United States. Curr Med Res Opin 2021; 37: 735-742. DOI:

Becher G, Jamieson L, Leman J. Palmoplantar pustulosis - a retrospective review of comorbid conditions. J Eur Acad Dermatol Venereol 2015; 29: 1854-1856. DOI:

Misiak-Galazka M, Wolska H, Galazka A, Kwiek B, Rudnicka L. General characteristics and comorbidities in patients with palmoplantar pustulosis. Acta Dermatovenerol Croat 2018; 26: 109-118.

Trattner H, Bluml S, Steiner I, Plut U, Radakovic S, Tanew A. Quality of life and comorbidities in palmoplantar pustulosis - a cross-sectional study on 102 patients. J Eur Acad Dermatol Venereol 2017; 31: 1681-1685. DOI:

Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C, et al. External review and validation of the Swedish national inpatient register. BMC Public Health 2011; 11: 450. DOI:

Löfvendahl S, Norlin JM, Schmitt-Egenolf M. Prevalence and incidence of palmoplantar pustulosis in Sweden: a population-based register study. Br J Dermatol 2021; 185: 945-951. DOI:

Ludvigsson JF, Almqvist C, Bonamy AK, Ljung R, Michaëlsson K, Neovius M, et al. Registers of the Swedish total population and their use in medical research. Eur J Epidemiol 2016; 31: 125-136. DOI:

National Board of Health and Welfare. [Instructions for NordDRG-Swedish version 2015] (in Swedish) (personal communication).

Swedish Association of Local Authorities and Regions. [Reference weights for inpatient and outpatient groups, NordDRG, 2015] (in Swedish). Available from

Wettermark B, Hammar N, Fored CM, Leimanis A, Otterblad Olausson P, Bergman U, et al. The new Swedish Prescribed Drug Register - opportunities for pharmacoepidemiological research and experience from the first six months. Pharmacoepidemiol Drug Saf 2007; 16: 726-735. DOI:

Miyazaki C, Sruamsiri R, Mahlich J, Jung W. Treatment patterns and healthcare resource utilization in palmoplantar pustulosis patients in Japan: a claims database study. PLoS One 2020; 15: e0232738. DOI:

Additional Files



How to Cite

Löfvendahl, S. ., Norlin, J. M., & Schmitt-Egenolf, M. (2023). Economic Burden of Palmoplantar Pustulosis in Sweden: A Population-based Register Study. Acta Dermato-Venereologica, 103, adv00843.

Most read articles by the same author(s)