An Acrodermatitis continua of hallopeau evolving into generalized pustular psoriasis: A case series

Abstract

Introduction: Acrodermatitis continua of Hallopeau (ACH) is a rare variant of localized pustular psoriasis which involved the fingertip and nails. ACH is rarely reported to evolve into generalized pustular psoriasis (GPP). This paper report 3 cases of GPP which initially manifested as ACH. This report aims to increase clinician awareness of localized pustular psoriasis history when met a case with GPP and to review a concept of the clinical course of ACH and its relation with GPP. Cases: Three patients which have been diagnosed with ACH, came to the hospital with the generalized manifestation of multiple pustules in the underlying erythematous base. Based on clinical manifestation and histopathology examination, all of them were diagnosed as GPP. Discussion: GPP was already known to have a genetic predisposition, with a mutation in gene IL36RN, CARD14, and APS13 have been documented in patients with GPP. The same genetic mutation in ACH was considered as the reason why this manifestation of localized pustular psoriasis could evolve into GPP. Conclusion: GPP could be preceded by the manifestation of ACH. The clinician should ask for a history of localized pustular psoriasis when met with a case of GPP.