Palmoplantar pustulosis (PPP) is a chronic inflammatory skin disease with recurrent blisters and sterile pustules on the palms and soles, often accompanied by itching, pain and disruption of the skin barrier. The study analyzed 9 patients with refractory PPP who did not respond to conventional therapy and apremilast (30 mg twice daily) and switched to tofacitinib (5 mg twice daily). By 12 weeks, PPPASI scores were significantly reduced in all patients, with the smallest reduction being 2.4 points and the largest being 16.4 points. Eight patients (88.9%) achieved PPPASI50 and one (11.1%) achieved PPPASI75. No serious adverse events were reported during treatment and follow-up. Switching to JAK inhibitors after apremilast failure represents an effective salvage treatment with good tolerability. Long-term efficacy and safety require verification in prospective studies.