{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:08:22Z","timestamp":1793725702666,"version":"4.6.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acrodermatitis continua of Hallopeau (ACH) is a rare, sterile pustular psoriasis variant refractory to many conventional treatments. The eruption typically occurs after local trauma or infection; other etiologies include neural, inflammatory, and genetic causes. Herein we reported a single case of a 64-year-old patient with ACH that was successfully treated with spesolimab for 19 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>\n                      A 64-year-old Chinese male with no personal or known family history of psoriasis had recurrent episodes of redness, swelling, and pustules in the nail bed on seven fingers with progressive degeneration of the nails. The patient was monitored as to the evolution of the disease over half of a year before he referred his case to our attention. A diagnosis of ACH was made, allowing for the administration of local steroids and oral acitretin. However, after 3 months of acitretin treatment, no improvement was observed. In December 2023, this patient came to our inpatient department; his modified nail psoriasis severity index score was 32. Before starting treatment, a comprehensive set of laboratory and instrumental tests were all found to be negative. Moreover, whole-exome sequencing was performed in our patient, and it revealed no rare coding variant in\n                      <jats:italic>IL36RN<\/jats:italic>\n                      ,\n                      <jats:italic>CARD14<\/jats:italic>\n                      , or\n                      <jats:italic>AP1S3<\/jats:italic>\n                      . Therefore, the patient was administrated with a dose of 900 mg spesolimab. After 10 days, the patient showed a significant decrease in discomfort and pain. In order to strengthen the therapeutic effect, he was given the second dose of 900 mg spesolimab after 4 weeks. After 19 weeks of spesolimab treatment, the patient\u2019s nail lesions showed complete resolution, and no adverse effects were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The case report suggests that spesolimab may offer significant therapeutic benefits for ACH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2024.1440102","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:11:07Z","timestamp":1736899867000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Case report: Successful treatment with spesolimab of acrodermatitis continua of Hallopeau in an older patient without IL36RN mutations"],"prefix":"10.3389","volume":"15","author":[{"given":"Jianfeng","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangfeng","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuling","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Yi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.5059","article-title":"Secukinumab for acrodermatitis continua of Hallopeau","volume":"153","author":"Muggli","year":"2017","journal-title":"JAMA Dermatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2011.04993.x","article-title":"Acrodermatitis continua of Hallopeau: evolution of treatment options","volume":"50","author":"Sehgal","year":"2011","journal-title":"Int J Dermatol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.16153","article-title":"A case of acrodermatitis continua of Hallopeau evolving into generalized pustular psoriasis successfully treated with guselkumab","volume":"62","author":"Yamamoto","year":"2023","journal-title":"Int J Dermatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1338285","article-title":"Successful treatment of acrodermatitis continua of Hallopeau coexisting with generalized pustular psoriasis with spesolimab: a case report","volume":"15","author":"Wen","year":"2024","journal-title":"Front Immunol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2147\/PTT.S98954","article-title":"Pustular psoriasis: pathophysiology and current treatment perspectives","volume":"6","author":"Benjegerdes","year":"2016","journal-title":"Psoriasis (Auckl)"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.4103\/ijdvl.IJDVL_581_19","article-title":"Three cases of IL36RN-associated pustulosis: An evolution of acrodermatitis continua of Hallopeau to generalized pustular psoriasis","volume":"86","author":"Chen","year":"2020","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2016.04.038","article-title":"IL36RN mutations affect protein expression and function: a basis for genotype-phenotype correlation in pustular diseases","volume":"136","author":"Tauber","year":"2016","journal-title":"J Invest Dermatol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/s00403-015-1611-x","article-title":"Correlation of IL36RN mutation with different clinical features of pustular psoriasis in Chinese patients","volume":"308","author":"Wang","year":"2016","journal-title":"Arch Dermatol Res"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.06.038","article-title":"Clinical and genetic differences between pustular psoriasis subtypes","volume":"143","author":"Twelves","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.15466","article-title":"Treatment of acrodermatitis continua of Hallopeau: A case series of 39 patients","volume":"47","author":"Kromer","year":"2020","journal-title":"J Dermatol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1111\/exd.14768","article-title":"Pathophysiology of generalized pustular psoriasis","volume":"32","author":"Young","year":"2023","journal-title":"Exp Dermatol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.12.024","article-title":"Unopposed IL-36 activity promotes clonal CD4+ T-cell responses with IL-17A production in generalized pustular psoriasis","volume":"138","author":"Arakawa","year":"2018","journal-title":"J Invest Dermatol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2012.490","article-title":"Rare pathogenic variants in IL36RN underlie a spectrum of psoriasis-associated pustular phenotypes","volume":"133","author":"Stetta-Kaffetzi","year":"2013","journal-title":"J Invest Dermatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1359481","article-title":"Spesolimab for generalized pustular psoriasis: a review of two key clinical trials supporting initial US regulatory approval","volume":"15","author":"Eran","year":"2024","journal-title":"Front Immunol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2023.6349","article-title":"Spesolimab response in a girl with acrodermatitis continua of Hallopeau","volume":"160","author":"Wang","year":"2024","journal-title":"JAMA Dermatol"}],"container-title":["Frontiers in 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