SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences

View all Images (22)

Acrodermatitis continua of Hallopeau in Adult
Other Resources UpToDate PubMed

Acrodermatitis continua of Hallopeau in Adult

Contributors: Saagar Jadeja, Susan Burgin MD
Other Resources UpToDate PubMed


Acrodermatitis continua of Hallopeau (ACH, also known as acrodermatitis perstans and dermatitis repens) is a rare subtype of pustular psoriasis. It typically presents as recurrent, painful pustules that involve one or more distal digit. Pustules are superseded by scaly psoriasiform plaques in involved areas. These in turn develop new pustules. The lesions may spread proximally to affect larger areas of the hands, feet, and forearms. ACH may involve the nail bed and distal phalanx, resulting in onycholysis, anonychia, and osteolysis of the distal phalanx.

ACH most commonly affects women over the age of 35 but can rarely affect children. The exact etiology is unknown. Mutations in the IL36RN gene have been associated with the development of ACH and pustular psoriasis.

ACH often has a chronic, relapsing course. There are rare reports of ACH developing from and progressing to generalized pustular psoriasis. Nonetheless, psoriatic arthritis is not commonly seen with ACH.


L40.2 – Acrodermatitis continua

83839005 – Acrodermatitis continua of Hallopeau

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

  • Palmoplantar pustulosis – Unlike ACH, palmoplantar pustulosis may initially present as pustules on the palms and soles without distal digit or nail bed involvement. 
  • Dyshidrotic dermatitis – Lesions tend to be predominantly vesicles rather than pustules. 
  • Acute paronychia (Bacterial paronychia, Drug-induced paronychia)
  • Chronic paronychia
  • Blistering distal dactylitis
  • Herpetic whitlow 
  • Cellulitis 
  • Infected Allergic contact dermatitis

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required


Subscription Required

Last Reviewed:06/08/2017
Last Updated:03/05/2023
Copyright © 2024 VisualDx®. All rights reserved.
Acrodermatitis continua of Hallopeau in Adult
A medical illustration showing key findings of Acrodermatitis continua of Hallopeau : Erythema, Hands and/or feet, Painful skin lesions, Relapsing pustular eruptions
Copyright © 2024 VisualDx®. All rights reserved.