Korean J Dermatol.  2024 Jan;62(1):53-57.

A Case of Improvement of Refractory Acrodermatitis Continua of Hallopeau with Guselkumab

• Kim JH
• Ha DL
• Jang YH

Abstract

Acrodermatitis continua of Hallopeau (ACH) is a rare type of pustular psoriasis that causes periungual sterile pustules, paronychia, onychodystrophy, osteolysis, and atrophic skin. This condition is known for being resistant to conventional anti-psoriatic treatments. Therefore, biologics have been explored as potential management options for ACH. A 48-year-old male presented with erythematous swelling, pustular eruptions, desquamation, and nail dystrophy on his left third fingertip for a year. Despite various anti-psoriatic treatments, including 308 nm excimer laser, oral cyclosporine, acitretin, and methotrexate, the symptoms persisted. After 9 years of experiencing this condition, the patient was started on guselkumab (an interleukin-23 inhibitor), and showed significant improvement after eight injections. The patient was in good health without any adverse effects. This case report highlights the potential effectiveness of guselkumab in the treatment of refractory ACH.

Keyword

Acrodermatitis continua of Hallopeau; Guselkumab