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

Dermatology. 2015;230(2):97-100. doi: 10.1159/000367690. Epub 2014 Nov 27.


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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acitretin / therapeutic use*
  • Acrodermatitis / blood
  • Acrodermatitis / 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*


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