Acitretin- and Tumor Necrosis Factor Inhibitor-Resistant Acrodermatitis Continua of Hallopeau Responsive to the Interleukin 1 Receptor Antagonist Anakinra

Acrodermatitis continua of Hallopeau is a variant of pustular psoriasis, which can be very difficult to treat. We describe a patient who could not be controlled with most approved drugs for psoriasis including acitretin, methotrexate, tumor necrosis factor (INF) inhibitors, and ustekinumab. The interleukin 1 (IL-1) receptor antagonist anakinra was rapidly effective and allowed controlling fever and pustulation. Targeting IL-1 could be an important alternative to the classic treatments of pustular psoriasis.