Previous literature documented some recalcitrant PG cases were successfully treated with secukinumab.4, 5 However, there are also several reported cases of PG being paradoxically induced by IL-17 inhibitors.6, 7, 8 Unlike previous reports, our case represented an exceptional secukinumab-induced PG occurring in a PPP patient with HLA-B51 positivity. The gene discussed is IL17A; the disease is palmoplantar pustulosis.