What is Acrodermatitis Continua?
Acrodermatitis continua is a rare form of psoriasis that afflicts the fingers and toes—and nothing else. Acrodermatitis continua is a chronic condition, meaning that it does not heal on its own and cannot be cured. Its symptoms primarily consist of a persistent pustular eruption on the tips of the fingers and toes which can be quite painful for many individuals.
Who gets Acrodermatitis Continua?
Acrodermatitis is a psoriasis-type condition. As such, it is at least partially autoimmune in nature. Because autoimmune conditions have a tendency to come in clusters, individuals that suffer from an autoimmune condition to begin with are more likely to also suffer from acrodermatitis continua.
However, there is something of a paradox underscoring this. Individuals that are immunocompromised are at a greater risk for acrodermatitis continua. More than 30% of individuals suffering from late-stage HIV develop some form of psoriasis condition. It is not completely clear why there is a link between psoriasis conditions and the immunodeficient at the same time there is a link between psoriasis and autoimmune conditions, and there is a profound lack of data that could be used to elucidate the full scope of this.
What causes Acrodermatitis Continua?
Acrodermatitis continua dos not have a singular, specific cause that can be pointed to. There is regrettably little data on the creation of psoriasis conditions, and most of the data comes from hospitals, drawn from individuals who are already ill. Because most of the data is skewed around individuals already suffering from some condition, it is difficult to employ it accurately.
There are two primary theories indicating the origin of psoriasis and acrodermatitis continua. They do not contradict each other and are likely both pertinent, but it is not clear to what degree they cooperate or coexist. The first of these indicates an autoimmune origin. The second indicates a dysfunction of the keratinocytes that are responsible for the creation of new skin cells.
The autoimmune component is hypothesized easily from the nature of psoriatic conditions, as an immune response occurs with nothing really there to provoke it. In acrodermatitis continua, this manifests as the formation of pustules on the fingertips and toes, as though there were an infection in that location requiring the response of the immune system to fight off. This is supported further by the effectiveness of immunosuppressants as a form of treatment. While acrodermatitis continua is a chronic condition that cannot be cured, per se, it can be treated in such a way as to make the symptoms subside, sometime with very long periods of time between recurrence. Immunosuppressants have been demonstrated as an effective form of treatment, which further contributes to the strong case of acrodermatitis continua’s being autoimmune.
However, there are exceptions to this. Acrodermatitis continua is, as a psoriasis condition, more likely in individuals that are immunocompromised. Those with late-stage HIV are as much as 30% likely to develop some form of psoriasis, including acrodermatitis continua. This seems to contradict the link between autoimmune conditions and dermatitis conditions.
What does Acrodermatitis Continua cause?
Acrodermatitis continua causes the formation of pustular eruptions on the fingertips and the toes. These eruptions can be quite uncomfortable, especially due to their location. Secondary conditions may include excessive dryness or thickness of the skin, similar to that which occurs in psoriasis.
The position of the pustules on the fingertips may make certain tasks difficult. Most of these, unfortunately, relate to job and study skills. Typing may be hindered, as may writing. The formation of pustules on the toes can hinder walking and other tasks that might put pressure on the feet. Because the toes are critical for walking, it is effectively impossible to avoid putting weight on them and still be mobile.
How serious is Acrodermatitis Continua?
Acrodermatitis continua is a serious condition in that it is invariably a chronic condition. Chronic conditions are those that cannot be eliminated through patience or medical intervention; they will not heal and they will not cure. Instead, they will remit and recur. Remission is when a disease goes away for a period of time, and recurrence is when it comes back. Chronic diseases can be made to remit with medical intervention but they may still recur later, depending on a large number of possible factors.
Acrodermatitis continua is not in and of itself dangerous. It does not have a mortality rate. However, it can be debilitating. The formation of lesions on the fingertips and toes can limit one’s ability to use their hands and can limit one’s ability to walk without pain. It cannot render one explicitly lame, nor can it paralyze the hands, but acrodermatitis continua can very easily render it almost impossible to commit oneself to certain tasks like typing due to the pain.
Acrodermatitis continua may indicate the potentiality of another autoimmune condition. This is not to say that acrodermatitis continua causes autoimmune conditions, but simply to acknowledge that autoimmune conditions come in clusters, and the presence of one may signify the presence or likelihood of another.
What does Acrodermatitis Continua treatment look like?
Acrodermatitis continua cannot be cured, at present. This is partly because very little data on it and other psoriatic conditions exists, and partly because there is no specific cure for autoimmune disorders on the whole. However, it can be treated very effectively, and it is possible for treatment to force full remission of acrodermatitis continua, nearly as though it were cured completely.
The primary treatment for acrodermatitis continua is the administration of immunosuppressants. Immunosuppressants restrict the immune system’s capacity to act. This does leave one more vulnerable to infection and illness just as the name would imply, and thus, there are risks. However, immunosuppressants have been demonstrated to be very effective in treating psoriatic conditions such as acrodermatitis continua. This form of acrodermatitis continua treatment is usually very effective.
Other symptomatic treatments may be appropriate to help cope with any of the pain or itching that the pustules on the fingertips and toes may cause. Over-the-counter analgesics are the go-to for pain management in this regard.
How do I know if I have Acrodermatitis Continua?
Acrodermatitis continua can be identified by its symptoms to a point. However, the pustules that form are very likely to resemble another ailment, like warts. As consequence, a superficial cosmetic analysis is frequently insufficient for the purposes of diagnosis. A biopsy or other form of close analysis may be required to properly diagnose acrodermatitis continua.
A positive diagnosis is obviously required before any sort of immunosuppressant treatment is even thought of as a possible solution.