Treatment of palmoplantar psoriasis with intramuscular alefacept

Alefacept is a dimeric fusion protein that consists of the extracellular CD2-binding portion of human lymphocyte function-associated antigen-3, which is linked to the Fc segment of human IgG₁.¹ Alefacept inhibits T-cell activation and proliferation, and induces apoptosis of memory-effector (CD45RO⁺) T cells in vitro,² limiting the inflammatory and uncontrolled keratinocyte proliferation seen in psoriatic lesions. Alefacept is the first biologic approved in the United States for the treatment of moderate to severe chronic plaque psoriasis. This report describes the use of alefacept in 2 patients with extensive and recalcitrant palmoplantar psoriasis who achieved significant improvements on alefacept therapy.