Psoriasis – Acrodermatitis Continua of Hallopeau

Acrodermatitis Continua of Hallopeau, also called Dermatitis Repens, is considered a subtype of Pustular Psoriasis and I occasionally encounter this skin disease in both my The Woodlands dermatology and Conroe dermatology offices.  Acrodermatitis of Hallopeau is most commonly seen in middle aged women and may begin after trauma to the fingers or toes.  Clinically, it appears as a pustule on a red scaly base and may involve the distal portion of only one or two digits.  The pustules may coalesce to form a “lake of pus” and the skin lesions can extend to the dorsum of the hands and feet.  This condition can be mutilating resulting in scarring of the skin, nail dystrophy, and loss of small areas in the bones.  Many patients with Acrodermatitis Continua of Hallopeau have initially been diagnosed as having a bacterial or fungal infection due to the clinical appearance, however cultures are always negative.  Acrodermatitis Continua of Hallopeau is very difficult to treat as it may not respond to topical steroids.