Efficacy of adalimumab for the treatment of refractory paediatric acrodermatitis continua of hallopeau

Acrodermatitis continua of Hallopeau (ACH) is a rare, chronic disease characterized by acropustular eruptions predominantly involving the distal phalanges of the hands and feet with marked involvement of the nail bed. The sterile pustules may coalesce to form groups of lesions, which, over time, may spread proximally to involve the dorsal side of the hands, forearms and feet. Pustulation of the nail bed and nail matrix are often associated with onychodystrophy and even anonychia of the involved digits. Atrophic skin changes, onychodystrophy and osteolysis are frequently present, causing painful and disabling lesions.