Acrodermatitis continua of Hallopeau on toes successfully treated with a two-compound product containing calcipotriol and betamethasone dipropionate

Objective: To investigate the efficacy of treating acrodermatitis continua of Hallopeau (ACH) with a new two-compound ointment. Background: ACH is a rare pustular eruption on the distal portions of the fingers and less often, on the toes. It is nowadays classified as a form of acropustular psoriasis that tends to be resistant to treatment. Methods: A 75-year old woman presented with pustules and hyperkeratotic erythematous papules, coalescing in plaques on the dorsal aspect of both great toes and on the perionychium of their nails. Diagnosis of ACH was based on clinical and histologic findings. We treated the patient with application of an ointment containing calcipotriol and betamethasone dipropionate twice daily for a month. Results: Therapeutic effect of the applied agent was impressively rapid with complete recovery of the lesions Conclusion: In our patient, calcipotriol betamethasone dipropionate ointment was an efficacious regimen in the treatment of ACH. In the era of biologics, old topical agents in combined forms remain valuable. Although calcipotriol alone or its combination with betamethasone have been reported to aggravate the disease in some cases, their beneficial role is important and they are worth considering as first line therapeutic agents in the management of various forms of pustular psoriasis.