A double-blind trial of clomocycline in the treatment of persistent palmoplantar pustulosis

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Abstract
Patients (60) with persistent palmoplantar pustulosis (PPP) were treated with clomocycline (Megaclor) in a double-blind, cross-over trial in an attempt to establish whether the condition responds to tetracycline. Each patient received 3 mo. each of clomocycline and placebo in random order. Forty patients completed the trial. Twenty-two failed to respond to either treatment, 15 improved on clomocycline, 2 improved on placebo and 1 improved on both treatments. These results are highly significant (P = 0.003) and suggest that clomocycline may suppress pustulation in some patients. The 22 non-responders were compared with the 18 responders for sex, age, length of history and associated psoriasis but no significant differences were found. Difficulties in assessment and the possibility of improvement being due to spontaneous remission are discussed. Further follow-up of both groups suggested that clomocycline used over long periods favorably influenced the course of the disease in the responder group.

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