Acrodermatitis continua of hallopeau: aggravating factors and treatment outcomes of 96 patients

Abstract

Background Acrodermatitis continua of Hallopeau (ACH) is a rare pustular psoriasis variant predominantly affects the distal phalanges of the fingers and toes. However, data on aggravating factors and treatment outcomes is limited.Objective This study aims to analyze the aggravating factors and treatment outcomes of ACH in a three-tertiary-hospital in South China.Methods We analyzed ACH patients from Dermatology Hospital of Southern Medical University, considering patient and disease characteristics along with treatment experiences.Results We identified 96 ACH patients. Various predisposing events were identified, including lifestyle factors, vaccination, stress, trauma, menstruation and drug exposure. A total of 293 systemic treatment courses were analyzed. 54.3% of patients received at least one biologic therapy, while 45.7% were treated with nonbiologic treatments. Acitretin was the most common therapy (20.5%). However, the effectiveness of systemic treatments was low (excellent response rate: 26.3%). Among non-biologic treatments, Acitretin showed a significant response in 30.0% (18/60) of cases, followed by cyclosporin (20.0%, 2/10). Among biologics, spesolimab had the best response rate at 75.0% (n = 3), followed by ixekizumab (44.4%, 8/18). Small molecule drugs did not yeild satisfactory outcomes in ACH treatment.Conclusion Identifying triggers and aggravating factors is crucial for effective ACH treatment. We suggest that biologics may be a useful first-line treatment option for clinicians managing ACH.

Keywords

• Acrodermatitis continua of hallopeau
• ACH
• aggravating factors
• treatment
• biologics