Del Rosario Nadine A, Nguyen Shayla H U, Nguyen Ethan Q H
Ms. Del Rosario and Dr. Nguyen are with the University of California at Riverside School of Medicine in Riverside, California.
Ms. Nguyen is with the University of California Riverside, in Riverside, California.
J Clin Aesthet Dermatol. 2025 Jun;18(6):22-25.
Acrodermatitis continua of Hallopeau (ACH) is a rare pustular psoriasis variant that presents as sterile pustules on the hands and feet with a relapsing course. This condition is not easily treated, but literature shows some cases are successfully controlled with biologics such as etanercept, adalimumab, secukinumab, and ustekinumab. Mixed connective tissue disease (MCTD) is a type of autoimmune disease and is rarely seen in the pediatric population. It is characterized by overlapping features of various autoimmune disorders, often involving scleroderma, systemic lupus erythematosus, polymyositis, and other organ dysfunction. MCTD is typically diagnosed with lab testing to indicate the presence of specific autoantibodies to a nuclear matrix protein, such as ribonucleoprotein. This communication emphasizes the importance of revisiting diagnoses in patients with persistent, refractory skin conditions and highlights the need for comprehensive evaluation in the presence of evolving or atypical presentations, especially when autoimmune diseases are suspected. Steps for diagnostic workup and treatment may provide clinical benefits to patients and serve as a reference for other clinicians. The course of treatment for ACH and MCTD in the pediatric and adolescent population is discussed.
哈洛佩奥连续性肢端皮炎（ACH）是一种罕见的脓疱型银屑病变体，表现为手足部无菌性脓疱，病程呈复发型。这种病症不易治疗，但文献表明一些病例可通过生物制剂如依那西普、阿达木单抗、司库奇尤单抗和乌司奴单抗成功控制。混合性结缔组织病（MCTD）是一种自身免疫性疾病，在儿科人群中很少见。其特征是具有各种自身免疫性疾病的重叠特征，常涉及硬皮病、系统性红斑狼疮、多发性肌炎及其他器官功能障碍。MCTD通常通过实验室检测来诊断，以表明存在针对核基质蛋白（如核糖核蛋白）的特定自身抗体。本文强调了对持续性、难治性皮肤病患者重新进行诊断的重要性，并突出了在出现病情演变或非典型表现时进行全面评估的必要性，尤其是在怀疑自身免疫性疾病时。诊断检查和治疗步骤可能会给患者带来临床益处，并为其他临床医生提供参考。本文还讨论了儿科和青少年人群中ACH和MCTD的治疗过程。
