ACRODERMATITIS CONTINUA OF HALLOPEAU

Acrodermatitis continua of Hallopeau (ACH) represents a rare variant of pustular psoriasis with a peculiar localization to the distal fingers.

Progressive cases can result in anonychia and osteolysis.
Average age of onset in one study was 55 years of age with equal sex ratio.

Sterile pustules on one or more fingers and fingertips which rupture leaving tender, eroded skin is characteristic. In the chronic stages, the skin may take on a papulosquamous appearance. In making the diagnosis, one should always take great care through various bacterial cultures to prove that the pustules are sterile as eczema can become secondarily infected, resulting in multiple pustules.

Involvement of the nail apparatus may result in nail dystrophy and even loss of the nail. Osteolysis has occurred.

Rarely, the condition may evolve into generalized pustular psoriasis.

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