Abstract
Palmoplantar psoriasis is a variant of psoriasis that affects the palms and soles. Despite the small body surface area affected, palmoplantar psoriasis can have significant implications on a patient's mental health, justifying the urgency in treating this condition. Palmoplantar psoriasis is also known to be challenging to treat. In this case report, we present a male who presented with a 15-year history of psoriasis with significant palmoplantar involvement, managed with topical and systemic therapies, achieving a minimal response. After trying other therapies including acitretin and adalimumab, we eventually started the patient on risankizumab, an anti-IL-23 antibody. Following the fourth dose of risankizumab, the patient's palmoplantar lesions completely resolved. We further discuss why risankizumab may be considered a treatment option in resistant palmoplantar psoriasis cases.