What is acrodermatitis continua of hallopeau (ACH)?

• ACH is a rare inflammatory disease characterised by pustular eruptions beginning in the tips of fingers and toes • The pustules may vary in extent over a chronic, recurrent course • ACH is often triggered by localized trauma or infection at the distal phalanx (the tip of the digit). 80% begin in only one digit, most commonly the thumb • Pustulation of the nail bed and its growth site (matrix) can result in onychodystrophy and anonychia (loss of nail) • There may be osteolysis resulting in a wasted and tapered tip of finger or toe • Evolution: Generalized pustular pso, conjonctivitis, oral inflammation, urethritis • Treatment: Topical potent CSteroids, tacrolimus, methotrexate