Patient description: A 35-year-old woman presents with history of acne and mild hirsutism. The primary evaluation revealed elevated testosterone levels. She recently noticed gradual enlargement of her hands and feet and recognized that her ring is getting small for her finger. There is some irregularity in her menstrual cycle as well as some nipple discharge. She also has positive history for snoring and headache. The physical examination revealed subtle facial features of acromegaly and prognathism. Visual fields are normal by confrontation. Hirsutism, soft tissue thickening and diaphoresis of the hands and feet are noted. Laboratory evaluation in the fasting state reveals IGF-1 of 968 ng/mL and random GH of 19.7 ng/mL. MRI reveals a macroadenoma with no invasion. She is on stable doses of octreotide LAR since her diagnosis was confirmed. She is married and has 2 children. She is using IUD as her contraceptive method.

Clinical trial eligibility criteria: eligible ages (years): 18.0-70.0,  Psoriasis Moderate to severe palmar plantar psoriasis based on physician's global assessment (PGA) Between 18 and 70 years of age Negative urine pregnancy test at screening and at baseline Sexually active men and women of child-bearing potential must agree to use a medically accepted form of contraception (birth control) during the exclusionary medicine wash-out period and throughout the study Ability to self inject study drug or have a designee who can do so Capable of understanding and giving written voluntary informed consent  Previous treatment with Enbrel® (etanercept) or similar drugs Receipt of investigational drugs or "biologics" within 4 weeks of the screening visit Evidence of skin conditions (e.g. eczema) other than psoriasis that would interfere with evaluations of the study medication Receipt of any biologic medication within the previous 6 months that resulted in a decreased white blood cell count (cells to help fight infections) Ultraviolet light treatment (e.g. UVB, PUVA) within one month prior to study drug initiation Receipt of immune-suppressing drugs other than Rheumatrex® (methotrexate) or Soriatane® (acetretin) within 4 weeks prior to the first dose of study drug. Medications you would not be allowed to take during this study for example, Cytoxan® (cyclosporine), Imuran® (azathioprine), or Sulfazine® (sulfasalazine). If you remain on Rheumatrex® (methotrexate) (≤25 mg/week) or Soriatane® (acitretin) (≤50 mg/day), you must be considered to have inadequate disease control in the opinion of the investigator based on physician's global assessment. You must have been on a stable dose of systemic treatment for at least 1 month prior to the start of the study medication. You will be required to maintain a stable dose of the systemic treatment throughout the study Use of topical steroids in the past 14 days unless they have been used for longer than 14 days and the severity of disease allows entry into study Systemic steroid use (prednisone, etc) Prior or concurrent use of Cytoxan® (cyclophosphamide) Elevated liver tests; red blood cell count less than normal; decreased platelet count (cells to help with blood clotting); decreased white blood cell count (cells to fight infection); kidney insufficiency