title: 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.affiliation: Dermatology Department, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
authors.forename: Jordane
authors.initials: J
authors.lastname: Saunier
authors.forename: Sébastien
authors.initials: S
authors.lastname: Debarbieux
authors.forename: Denis
authors.initials: D
authors.lastname: Jullien
authors.forename: Lorna
authors.initials: L
authors.lastname: Garnier
authors.forename: Stéphane
authors.initials: S
authors.lastname: Dalle
authors.forename: Luc
authors.initials: L
authors.lastname: Thomas
mesh_terms: D017255:Acitretin / Q000627:therapeutic use*; D000169:Acrodermatitis / Q000097:blood / Q000188:drug therapy*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D000068800:Etanercept / Q000627:therapeutic use; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use; D053583:Interleukin-1beta / Q000097:blood; D007641:Keratolytic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D000079424:Tumor Necrosis Factor Inhibitors; D000069549:Ustekinumab / Q000627:therapeutic use*
chemical_list: D003879:Dermatologic Agents; C508585:IL1B protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; D007641:Keratolytic Agents; D000079424:Tumor Necrosis Factor Inhibitors; D000069285:Infliximab; D000069549:Ustekinumab; D017255:Acitretin; D000068800:Etanercept