Acrodermatitis continua of Hallopeau treated with cyclosporin A. A case report

Background. Acrodermatitis continua of Hallopeau is a dermatosis which presents various difficulties for treatment; the aim of this work therefore is to evaluate the efficacy and tolerability of oral cyclosporin A in the treatment of this disease. Methods. A 31-year-old white woman, with neither family nor personal history of psoriasis, who had been suffering from acrodermatitis continua of Hallopeau for approximately 6 weeks with lesions located to fingers and toes and severe onychodystrophy, was treated with oral cyclosporin A at the dosage of 5 mg/kg/day for 2 months. The dosage was gradually reduced to 3 mg/kg/day and continued for another month. Routine laboratory tests and blood pressure checks were carried out at the beginning and throughout the treatment. Results. After two months at the full dosage therapy, there was a marked improvement in the disease, with clearing of erythema and papulo-pustular lesions of the distal phalanges of hands and feet. Incomplete growth of nails was noted. The drug was well tolerated by the patient. The improvement has been subsequently continued and six months after the end of treatment no relapses or psoriasic lesions have been observed. Conclusions. On the basis of the authors' experience oral cyclosporin A, at dosage up to 5 mg/kg/day, is a good therapeutic option for the treatment of acrodermatitis continua of Hallopeau.