Treatment of acrodermatitis continua of hallopeau with ixekizumab

Acrodermatitis continua of hallopeau (ACH) is a rare chronic inflammatory variant of pustular psoriasis often restricted to the distal portions the digits in the hands and feet. ACH is of a chronic relapsing nature and is invariably recalcitrant to many available topical and systemic anti-psoriatic therapies. On account of its low prevalence and high resistance to treatments, no clinical guideline of ACH exists. We present a patient with ACH resistant to multiple therapies, including the biologic adalimumab, who was successfully treated with an IL-17 inhibitor (ixekizumab). We believe our unique treatment with an excellent outcome may assist other dermatologists if faced with this condition.