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Morón-Ocaña JM, Pérez-Gil A. Effective management of acrodermatitis continua of Hallopeau with guselkumab in a Wiskott-Aldrich syndrome patient. Int J Dermatol 2024. [PMID: 39223723 DOI: 10.1111/ijd.17468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 08/06/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024]
Affiliation(s)
| | - Amalia Pérez-Gil
- Department of Dermatology, Virgen de Valme Hospital, Sevilla, Spain
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O'Malley S, Duff E, Collins S. Paediatric acrodermatitis continua of Hallopeau: perspectives of a patient and their mother. Clin Exp Dermatol 2023; 49:92-93. [PMID: 37758513 DOI: 10.1093/ced/llad333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
Rare dermatological conditions can present profound and unique challenges to paediatric patients and their families. This spans from the challenge of referral to appropriate services to understanding of peers, educators and extended family members. We explore the perspectives of a mother and a patient on the difficulty faced navigating a case of acrodermatitis continua of Hallopeau, from their years managing the condition themselves to the rapid response the patient had to fortnightly adalimumab therapy and the positive impact on their lives.
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Affiliation(s)
- Seán O'Malley
- Dermatology Department, Our Lady of Lourdes Hospital, Drogheda, Louth, Ireland
| | - Eimear Duff
- Dermatology Department, Our Lady of Lourdes Hospital, Drogheda, Louth, Ireland
- Dermatology Department, University Hospital Limerick, Limerick, Ireland
| | - Sinead Collins
- Dermatology Department, Our Lady of Lourdes Hospital, Drogheda, Louth, Ireland
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Chularojanamontri L, Rattanakorn K, Julanon N, Chuamanochan M, Griffiths CEM. Acrodermatitis continua of Hallopeau and generalised pustular psoriasis: Should they be the same or different entities? Exp Dermatol 2023; 32:1235-1245. [PMID: 37057764 DOI: 10.1111/exd.14805] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/15/2023]
Abstract
Pustular psoriasis is characterised by eruptions of neutrophilic sterile pustules. The European Rare and Severe Psoriasis Expert Network consensus defines pustular psoriasis into three subtypes; generalised pustular psoriasis (GPP), palmoplantar pustulosis and acrodermatitis continua of Hallopeau (ACH). Mixed forms are categorised according to their predominant features. However, the Japanese Dermatological Association includes ACH under the diagnosis of GPP. This article aims to review the similarities and differences between ACH and GPP. Based on our review, interleukin (IL)-36RN mutations, the most frequent genetic findings in pustular psoriasis are found most commonly in GPP, followed by ACH. Genotypes of IL-36RN mutations among GPP patients and ACH patients are different between European and Asian ethnicities. IL-36 signalling pathway is the main mechanism. Metabolic diseases are common comorbidities and joint involvement can occur in 20.5%-36.4% of both conditions. Associated plaque psoriasis is more common in GPP than in ACH. Generally, ACH, even the generalised type, does not have systemic inflammation whereas GPP can occur with or without systemic inflammation. ACH can occur before, simultaneously, or after the development of GPP. However, response to treatment for GPP and ACH even in the same patients appear to be different. ACH seemed to be more recalcitrant to treatment than GPP but severe flare of GPP can lead to morbidity and mortality. Although GPP and ACH share genotypes and pathogenesis, we believe that ACH should be classified separately from GPP, and not under diagnosis of GPP. Future research is warranted to satisfactorily distinguish the two conditions.
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Affiliation(s)
- Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Krittaya Rattanakorn
- Division of Dermatology, Department of Medicine, Chiangrai Prachanukroh Hospital, Phayao, Thailand
| | - Narachai Julanon
- Division of Dermatology, Department of Medicine, Faculty of Medicine Srinagarind Hospital Khon Kean University, Khon Kean, Thailand
| | - Mati Chuamanochan
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Christopher E M Griffiths
- Dermatology Centre, Salford Royal Hospital, University of Manchester, NIHR Manchester Biomedical Research Centre Manchester, Salford Manchester, UK
- Department of Dermatology, King's College Hospital, King's College London, London, UK
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Nguyen A, D’Aguanno K, Ridha Z, Tsoukas A, Netchiporouk E. Successful treatment of acrodermatitis continua of Hallopeau with tildrakizumab: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231180775. [PMID: 37359284 PMCID: PMC10285597 DOI: 10.1177/2050313x231180775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/01/2023] [Indexed: 06/28/2023] Open
Abstract
Acrodermatitis continua of Hallopeau is a rare, localized variant of pustular psoriasis commonly associated with join disease and severe quality of life impairment. While there are no standard treatment guidelines, therapies used for psoriasis vulgaris are commonly tried. We report a case of severe acrodermatitis continua of Hallopeau in a patient with multiple comorbidities (advanced malignancy, recurrent empyema, psoriatic arthritis) where tildrakizumab lead to a rapid resolution of skin and joint disease which was maintained 1 year later. To date, there are only four cases reporting the use of IL-23 inhibitors class in acrodermatitis continua of Hallopeau and none for tildrakizumab. However, IL-23 inhibitors should be strongly considered among the treatment of choice for acrodermatitis continua of Hallopeau, especially in patients with ongoing malignancy and/or high risk of infections.
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Affiliation(s)
- Alex Nguyen
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | | | - Zainab Ridha
- Division of Dermatology, McGill University Health Center, Montreal, QC, Canada
| | - Alexander Tsoukas
- Division of Rheumatology, McGill University Health Center, Montreal, QC, Canada
| | - Elena Netchiporouk
- Division of Dermatology, McGill University Health Center, Montreal, QC, Canada
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Yamamoto H, Kamiya K, Okada H, Maekawa T, Komine M, Ohtsuki M. A case of acrodermatitis continua of Hallopeau evolving into generalized pustular psoriasis successfully treated with guselkumab. Int J Dermatol 2023; 62:269-270. [PMID: 35187654 DOI: 10.1111/ijd.16153] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/15/2022] [Accepted: 02/07/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Hiroki Yamamoto
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Koji Kamiya
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Hirofumi Okada
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Takeo Maekawa
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Mayumi Komine
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
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Rosi E, Fastame MT, Di Cesare A, Prignano F. Targeting IL-17A for the treatment of pustular psoriasis: a comprehensive review. Expert Opin Biol Ther 2022; 22:1475-1487. [PMID: 35997143 DOI: 10.1080/14712598.2022.2116978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Pustular psoriasis (PP) is a rare subtype of psoriasis. Overall, the growing evidence - in particular for acute generalized PP (GPP) - supports that it is a separate entity with a specific pathogenetic pathway. Interleukin (IL)-17/T-helper 17 (Th17) axis involvement may play an important role in the pathophysiology of PP. Biologicals, often required to achieve clinical remission, have changed the treatment of PP. AREAS COVERED We provide the reader with an overview of all the available evidence on the use of the antibody-based therapy targeting IL-17A in patients with PP. EXPERT OPINION Although papers reported in this review do not provide definitive evidence (due to methodological limitations) to support the use of IL-17 inhibitors as potential first-line for the treatment of PP, based on our own experience and according to most of the reported literature, targeting IL-17A, may represent the best therapeutical approach in this peculiar clinical spectrum of psoriasis.
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Affiliation(s)
- Elia Rosi
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Maria Thais Fastame
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Antonella Di Cesare
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Francesca Prignano
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
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Buononato D, Licata G, Gambardella A, De Rosa A, Calabrese G, Argenziano G. A case of Acrodermatitis continua of Hallopeau successfully treated with guselkumab. Dermatol Ther 2022; 35:e15514. [PMID: 35420733 DOI: 10.1111/dth.15514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/20/2022] [Accepted: 04/12/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Dario Buononato
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, Italy
| | - Gaetano Licata
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, Italy
| | - Alessio Gambardella
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, Italy
| | - Alina De Rosa
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, Italy
| | - Giulia Calabrese
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, Italy
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Rizzetto G, Diotallevi F, Molinelli E, Radi G, Offidani AM. Certolizumab Pegol: A New Therapeutic Approach for Acrodermatitis Continua of Hallopeau. Skin Appendage Disord 2022; 8:146-149. [PMID: 35419415 PMCID: PMC8928201 DOI: 10.1159/000519144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/14/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Acrodermatitis continua of Hallopeau (ACH) is a rare, chronic, and recurrent form of pustular psoriasis (PP) localized to one or more digits. Due to the rarity of ACH, no clear treatment guidelines are currently available, making the therapeutic approach more complex. Case Presentation We report the first case of a young woman with ACH who was successfully treated with certolizumab pegol (CZP). Discussion/Conclusion PP and ACH are difficult to treat, and biologics may be an option more manageable than cyclosporine. CZP is the safest biologic therapy during pregnancy, so there is low risk in prescribing it in women with childbearing potential. However, continuing biological therapy during pregnancy always involves an assessment of the clinical benefits, which must outweigh the risks.
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Affiliation(s)
- Giulio Rizzetto
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | | | - Elisa Molinelli
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - Giulia Radi
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - Anna Maria Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
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Ngo JL, Ramirez Quizon M, Balagat R. A rare case of Acrodermatitis continua of Hallopeau successfully treated with topical calcipotriol/betamethasone dipropionate ointment associated with Jaccaud’s arthropathy: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221136766. [PMCID: PMC9666851 DOI: 10.1177/2050313x221136766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Acrodermatitis continua of Hallopeau (ACH) is a rare and localized form of pustular psoriasis that can lead to irreversible anonychia whereas Jaccoud’s arthropathy (JA) is a rare non-articular condition characterized by a deforming non-erosive arthropathy involving the digits. This case describes the first reported association of these two rare conditions in a 73-year-old Filipino male who was treated topically until remission of ACH. Because calcipotriol/betamethasone ointment works better and faster than clobetasol ointment, it may be considered as a preferred first-line treatment for ACH. This case also highlights the evaluation of joint symptoms in the context of psoriatic arthritis and JA, along with a discussion of its management. A multidisciplinary approach involving dermatology, rheumatology, and physiatry is essential in the care of these two rare conditions.
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Affiliation(s)
| | | | - Rogelio Balagat
- Department of Internal Medicine, Rizal Medical Center, Pasig, Philippines
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Mir-Bonafé M, Mir-Bonafé JF. Visual Dermatology: Acrodermatitis Continua of Hallopeau. J Cutan Med Surg 2020; 24:634. [DOI: 10.1177/1203475420943873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marc Mir-Bonafé
- Department of Dermatology, Hospital Universitario Central de Asturias, Oviedo, Spain
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Kromer C, Loewe E, Schaarschmidt ML, Pinter A, Gerdes S, Celis D, Poortinga S, Wilsmann-Theis D, Mössner R. Treatment of acrodermatitis continua of Hallopeau: A case series of 39 patients. J Dermatol 2020; 47:989-997. [PMID: 32632983 DOI: 10.1111/1346-8138.15466] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/18/2020] [Indexed: 01/10/2023]
Abstract
Acrodermatitis continua of Hallopeau (ACH) is a rare chronic inflammatory skin disease. Treatment is extremely challenging and mostly based on empirics as there is only scarce evidence from case reports and few small case series. In this retrospective study, patients with ACH treated at five university medical centers were analyzed according to patient and disease characteristics and treatment experience. We identified 39 patients with ACH with a mean age of 54.4 years at onset, of whom 22 (56.4%) were female. A total of 115 systemic treatment courses were analyzed with methotrexate as the most common therapy (27.0%). Overall, effectiveness of systemic treatments was low (excellent response rate: 14.8%). Among non-biologics, excellent response was noted in 21.1% (4/19) of treatment courses with methotrexate, followed by acitretin (13.3%; 2/15). Among biologics, guselkumab (excellent response: 100%; 2/2), secukinumab (excellent response: 42.9%; 3/7) and adalimumab (excellent response: 20.0%; 2/10) were most efficacious. The median drug survival was 7.0 months and did not differ significantly between the subgroup of non-biologic and biologic therapies. To our knowledge, this is the largest case series in ACH investigating patient characteristics and treatment outcomes. Based on our treatment experience, we suggest a treatment algorithm starting with acitretin or methotrexate as first-line therapy, followed by biologics. Cyclosporin may be used for short-term control. However, none of the applied systemic therapies yielded satisfying efficacy in our cohort. In patients with primary non-response, switch of treatment should be evaluated timely on an individual basis, considering possible irreversible disease complications such as nail loss. More research with prospective design is needed to further evaluate traditional and also particularly newer antipsoriatic drugs in ACH.
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Affiliation(s)
- Christian Kromer
- Department of Dermatology, Venereology and Allergology, University Medical Center, Göttingen, Germany
| | - Emilia Loewe
- Department of Dermatology, Venereology and Allergology, University Medical Center, Göttingen, Germany
| | | | - Andreas Pinter
- Department of Dermatology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sascha Gerdes
- Psoriasis Center, Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Daniel Celis
- Faculty of Economic Sciences, Göttingen University, Göttingen, Germany
| | - Sietske Poortinga
- Department of Dermatology and Allergy, University Bonn, Bonn, Germany
| | | | - Rotraut Mössner
- Department of Dermatology, Venereology and Allergology, University Medical Center, Göttingen, Germany
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