Acrodermatitis continua of Hallopeau treated successfully with ustekinumab and acitretin after failure of tumour necrosis factor blockade and anakinra.

Abstract

Acrodermatitis continua of Hallopeau (ACH) is a rare form of chronic acral pustular eruption. Considered to be a variant of pustular psoriasis, it is a refractory condition that may not respond to conventional treatments. We report herein the case of a 53-year-old patient whose ACH was refractory to all conventional systemic treatment modalities and to anti-tumour necrosis factor. Because he had increased plasma levels of interleukin (IL)-1β, he received anakinra for 7 weeks, without further improvement however. Achievement of complete response was obtained with ustekinumab 90 mg s.c. every 12 weeks combined with acitretin; the plasma level of IL-1β concomitantly returned to normal. This case report is associated with a review on recent data on ACH treatment with biological agents, including anakinra and ustekinumab.

• Authors: Jordane Saunier, Sébastien Debarbieux, Denis Jullien, Lorna Garnier, Stéphane Dalle, Luc Thomas
• Journal: Dermatology (Basel, Switzerland) (Dermatology) Vol. 230 Issue 2 Pg. 97-100 ( 2015) ISSN: 1421-9832 [Electronic] Switzerland
• PMID: 25471551 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: © 2014 S. Karger AG, Basel.

Chemical References

• Dermatologic Agents
• IL1B protein, human
• Interleukin 1 Receptor Antagonist Protein
• Interleukin-1beta
• Keratolytic Agents
• Tumor Necrosis Factor Inhibitors
• Infliximab
• Ustekinumab
• Acitretin
• Etanercept

Topics

• Acitretin (therapeutic use)
• Acrodermatitis (blood, drug therapy)
• Dermatologic Agents (therapeutic use)
• Drug Therapy, Combination
• Etanercept (therapeutic use)
• Humans
• Infliximab (therapeutic use)
• Interleukin 1 Receptor Antagonist Protein (therapeutic use)
• Interleukin-1beta (blood)
• Keratolytic Agents (therapeutic use)
• Male
• Middle Aged
• Retreatment
• Tumor Necrosis Factor Inhibitors
• Ustekinumab (therapeutic use)