Korean J Dermatol.  2012 Jan;50(1):92-94.

A Case of Acrodermatitis Continua of Hallopeau Treated with Etanercept

• Park J
• Lee Y
• Noh S
• Cho S
• Park CO
• Lee KH

Abstract

Acrodermatitis continua of Hallopeau (ACH) is a rare form of acropustular eruption characterized by a presence of aseptic pustules on inflammatory periungual or subungual regions. Frequently accompanied by paronychia, atrophic skin changes, onychodystrophy, and osteolysis of distal phalanges of the digits, it is considered to be a variant of pustular psoriasis with a chronic relapsing course and refractoriness to many therapeutic modalities. Here, we present a case of a 45-year-old female who presented with multiple pustules pathologically diagnosed as pustular psoriasis on her left thumb. She suffered from ACH for over a decade, and in the process experienced frequent relapses and showed poor response to numerous treatment modalities such as narrow band UVB, topical steroid, steroid intralesional injection, oral retinoids, 308 nm excimer laser, and oral immune suppressants. However, the patient showed dramatic clinical improvements to administration of etanercept (TNF-alpha antagonist, twice a week) for a period of one month. The cessation of etanercept led to recurrence of symptoms and marked deterioration of the skin lesion within a month again, but the re-initiation of treatment soon relieved the problem. After completion of a three months trial of etanercept, the cutaneous lesion subsided, and the patient is now successfully controlled with topical steroid maintenance therapy. Hereby, we report a patient with ACH successfully treated with etanercept.

Keyword

Acrodermatitis continua of Hallopeau; Etanercept; Pustular psoriasis

MeSH Terms

Acrodermatitis
Female
Humans
Immunoglobulin G
Injections, Intralesional
Lasers, Excimer
Middle Aged
Osteolysis
Paronychia
Psoriasis
Receptors, Tumor Necrosis Factor
Recurrence
Retinoids
Skin
Thumb
Etanercept
Immunoglobulin G
Receptors, Tumor Necrosis Factor
Retinoids