Highly Resistant Acrodermatitis Continua of Hallopeau and Pustular Psoriasis

Frew, John W.; Murrell, Dédée F.

doi:10.1159/000464140

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…According to the latest data, IL-17 suppression provided by secukinumab is effective in the treatment of psoriasis and psoriatic arthritis1,6–8 and demonstrated notable anti-inflammatory effects. Secukinumab is a fully human IgG1 which targets and inhibits IL-17A.…”

Section: Discussionmentioning

confidence: 99%

“…IL-17 was shown to have an essential role in the pro-inflammatory processes in psoriasis: it directly affects keratinocytes causing their hyperplasia, acanthosis, and hyperkeratosis. It leads to accumulation of neutrophils and T-lymphocytes in the epidermis and further escalation of chronic inflammation 6,7…”

Section: Discussionmentioning

confidence: 99%

“…Typically, ACH demonstrates low or no stable response to SOC treatments. Multiple therapies include methotrexate, systemic retinoids, cyclosporin A, biologics (adalimumab, infliximab), and others; however, none of the current treatments results into the longer term disease control 4–6. Here our experience of ACH treatment is presented.…”

Section: Introductionmentioning

confidence: 99%

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<p>Outcomes of various types of therapy in patients with treatment-resistant acrodermatitis continua of Hallopeau</p>

Смирнова¹,

Vertieva²,

Olisova³

et al. 2019

BTT

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Background: Chronic acrodermatitis continua of Hallopeau (ACH) is a rare form of pustular psoriasis predominantly affecting the distal phalanges of the fingers and toes. The disease manifests by pustular rash with marked infiltration, fissures, and often results into severe dystrophy of nail plates. ACH is refractory to most of psoriasis standard of care (SOC) therapies. Objective: The objective of this study is to assess the prospects of secukinumab therapy of ACH based on current clinical observation. Methods: We observed a female patient with ACH. Number of SOC treatments were applied in that case including local PUVA therapy, systemic retinoids, methotrexate, and biologic agents. Result: Secukinumab, a IL-17 inhibitor, demonstrated pronounced clinical effect in the case of ACH refractory to other SOC therapies. Conclusion: IL-17 inhibition provided by secukinumab was linked to clinically meaningful improvement in the heavily pretreated ACH. Further exploration and clinical studies may be important to provide more data on secukinumab effects in ACH.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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<p>Outcomes of various types of therapy in patients with treatment-resistant acrodermatitis continua of Hallopeau</p>

Смирнова¹,

Vertieva²,

Olisova³

et al. 2019

BTT

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“…20 In addition, treatment with systemic therapies such as oral corticosteroids, methotrexate, cyclosporine, retinoids, tetracyclines, colchicine, and dapsone has been inconsistent, and patients often fail or lose efficacy over time. 18,21,22 Apremilast has also been recently attempted with mixed results, 23,24 and brachytherapy was effective in a single case. 25 The recent advent of the use of biologics has revolutionized the treatment of a wide range of dermatological conditions.…”

Section: Management Of Achmentioning

confidence: 99%

The Use of Biologic Therapy in the Treatment of Acrodermatitis Continua of Hallopeau: A Review

et al. 2019

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Acrodermatitis continua of Hallopeau is a rare subtype of pustular psoriasis that presents as a sterile, pustular eruption commonly in the finger tips and toes. This disease inflicts both the skin and nail bed, and causes severe disfigurement of the distal phalanges. Because it is a variant of pustular psoriasis, acrodermatitis continua of Hallopeau is commonly managed with antipsoriatic medications. Common approaches to treatment include topical therapy (corticosteroids, vitamin D analogs, and calcineurin inhibitors), systemic therapy, and in more severe cases, biologic therapy. This review will discuss how acrodermatitis continua of Hallopeau is diagnosed and how it is managed, with a particular emphasis on the use of biologics.

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“…ACH is also resistant to many conventional topical and systemic anti-psoriatic therapies, such as calcineurin inhibitors, phototherapy and methotrexate. 1 , 2 However, the introduction of biological agents has revolutionized the treatment of psoriasis, even in children and elderly patients, in whom they have demonstrated excellent efficacy and safety, 3 , 4 thus making them viable for the therapy of ACH.…”

Section: Introductionmentioning

confidence: 99%

Acrodermatitis Continua of Hallopeau Successfully Treated with Ustekinumab: A Case Report and Literature Review

Shi¹,

Zeng²,

Huang³

et al. 2023

CCID

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Acrodermatitis continua of Hallopeau (ACH) is a rare variant of pustular psoriasis that presents as a sterile pustular eruption of the periungual and subungual regions. It affects the skin and nail bed and can lead to distal phalangeal destruction as the disease progresses. ACH is an incurable disease that requires long-term maintenance therapy to prevent any complications. Because ACH is a variant of pustular psoriasis, it is commonly treated with anti-psoriatic therapies. Unfortunately, it is resistant to many available anti-psoriatic therapies, and there are no clinical guidelines for it; the treatment is therefore highly challenging. Current treatment strategies are mostly based on a few case reports and case series. In this study, we present a case of ACH in a 24-year-old man with a long history of severe skin lesions and overt onychodystrophy, successfully treated with Ustekinumab. In this patient, we observed rapid improvement in skin lesions and symptoms. Ustekinumab can considerably improve other symptoms besides plaque psoriasis. The treatment and excellent outcomes of Ustekinumab may provide clinical benefits to more patients and serve as a reference for other dermatologists.

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Highly Resistant Acrodermatitis Continua of Hallopeau and Pustular Psoriasis

Cited by 4 publications

References 7 publications

<p>Outcomes of various types of therapy in patients with treatment-resistant acrodermatitis continua of Hallopeau</p>

<p>Outcomes of various types of therapy in patients with treatment-resistant acrodermatitis continua of Hallopeau</p>

The Use of Biologic Therapy in the Treatment of Acrodermatitis Continua of Hallopeau: A Review

Acrodermatitis Continua of Hallopeau Successfully Treated with Ustekinumab: A Case Report and Literature Review

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