Treatment of acrodermatitis continua of Hallopeau with TNF-blocking agents: Case report and review

Lluís Puig, Didac Barco, Eva Vilarrasa, Agustín Alomar

Research output: Contribution to journalArticleResearchpeer-review

31 Citations (Scopus)

Abstract

Acrodermatitis continua of Hallopeau (ACH) is a rare acropustular eruption, characterized by sterile pustules, paronychia and atrophic skin changes, onychodystrophy and osteolysis of the distal phalanges of the fingers and toes. It is considered to be a variant of pustular psoriasis with a chronic relapsing course and frequent refractoriness to many therapeutic modalities, which can be amenable to successful treatment by tumor necrosis factor α antagonists. We report 1 patient with pustular psoriasis and ACH whom we have treated successfully with etanercept (for 30 months) and then adalimumab (for 13 months and ongoing). Blanching was initially achieved with etanercept 50 mg twice a week, but suppression of periungual inflammation then required combination therapy with etanercept 50 mg twice a week and methotrexate 10 mg weekly; lower doses of both drugs did not allow complete control of the disease. Eventually, adalimumab 40 mg every 2 weeks has provided the most cost-effective response in this patient, allowing maintenance of response with partial nail regrowth under monotherapy. Copyright © 2010 S. Karger AG, Basel.
Original languageEnglish
Pages (from-to)154-158
JournalDermatology
Volume220
Issue number2
DOIs
Publication statusPublished - 1 Mar 2010

Keywords

  • Acrodermatitis continua of Hallopeau
  • Adalimumab
  • Etanercept
  • Infliximab
  • Methotrexate
  • Psoriasis
  • Pustular psoriasis

Fingerprint Dive into the research topics of 'Treatment of acrodermatitis continua of Hallopeau with TNF-blocking agents: Case report and review'. Together they form a unique fingerprint.

Cite this