Successful therapy of acrodermatitis continua of Hallopeau with IL‐23 blockers –two new cases

Abstract

Hallopeau with IL-23 blockers -two new casesDear Editors, Acrodermatitis continua of Hallopeau (ACH) is a very rare inflammatory, often chronic pustular skin and nail bed disease of the distal phalanges, which can result in permanent anonychia and disfigurement of the distal phalanges. It remains controversial whether ACH is a localized form of pustular psoriasis or a separate entity [1]. For systemic therapy, only retinoids are licensed for ACH under the indication of pustular psoriasis of hands and feet. However, as psoriasis vulgaris (PsO) and psoriatic arthritis (PsA) are often comorbid diseases in ACH patients, there is experience in ACH with drugs that are standard therapies for PsO or PsA, and these therapies have also been used in an off-label setting in ACH patients without these comorbidities [2].In a review of 35 patients with ACH treated with biologicals also used in PsO, a good response was observed [3]. On the other hand, a multicenter case series of 39 consecutive Clinical LetterTable 1 Characteristics of ACH patients and treatment characteristics with IL-23 antagonists. New cases Follow up of already reported patients a Case 1 Case 2 Case 3 a Case 4 a Sex Female Male Male Female Age (years) b 60 67 61 71 Age at onset of ACH (years) 58 42 55 43 Clinical extent Both hands and feet Left hand and both feet Both hands and feet Both hands and one foot Family history of pustular psoriasis

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

“…15 We have identified five case reports of patients with ACH treated with IL-12/23 inhibitors and four case reports of patients with ACH treated with IL-23 inhibitors in the literature, involving a total of twelve patients with ACH, as detailed in Table 1. 11,[16][17][18][19][20][21][22][23] Five patients were treated with Guselkumab, two with Risankizumab and five with Ustekinumab. Ustekinumab was reported to be effective, either as monotherapy or along with acitretin, 11,[20][21][22][23] but only one patient achieved a satisfactory clinical response at the recommended dose and frequency.…”

Aktuelle Entwicklungen und Perspektiven bei Psoriasis

“…2 Seither erschienen in dieser Zeitschrift Publikationen zur Psoriasis in dreistelliger Zahl. In jüngster Zeit umspannen die Themen grundlegende pathophysiologische Aspekte, [3][4][5] therapeutische Ansätze, [6][7][8][9][10][11] epidemiologische Fragen, 12 diagnostische und klinische Entwicklungen, [13][14][15] psychosoziale Aspekte, [16][17][18] bis hin zu Versorgungsforschung und Registerstudien. [19][20][21][22] Empfehlungen zur praktischen Umsetzung neuer Erkenntnisse kulminieren schließlich in Leitlinien.…”

Current developments and perspectives in psoriasis

“…2 Since then, publications on psoriasis have appeared in this journal in three-digit numbers. More recently, topics have spanned basic pathophysiologic aspects, [3][4][5] therapeutic approaches, [6][7][8][9][10][11] epidemiologic issues, 12 diagnostic and clinical developments, [13][14][15] psychosocial aspects, [16][17][18] as well as health services research and registry studies. [19][20][21][22] Recommendations for practical implementation of new findings ultimately culminate in guidelines.…”