Acrodermatitis Continua of Hallopeau —A Case with Lesions Localized at Bilateral Thumbs Successfully Treated with Dapsone—

A 66-year-old male suffered from painful pustular eruptions of acrodermatitis continua of Hallopeau on bilateral thumbs for about 2 years, with associated nail dystrophy and markedly disabled manual skills. Initial treatment with topical corticosteroids, tars and calcipotriol failed to improve the acral lesions. Dapsone therapy began at a dose of 200 mg / day, which cleared the acral lesions within two weeks of therapy. However, new lesions relapsed when the dose was tapered to 150 mg / day. Increasing dapsone back to 200 mg / day was followed by another clearance of the acral pustules. During a total course of 6-week therapy, no dapsone-related side effects were noted. The patient remained symptom-free and nail growth was noted at the follow-up visit 3 months after the medications were discontinued. (Dermatol Sinica 21 : 165-170, 2003)