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To the Editor.—
Notowicz et al's report in the January Archives (114:129, 1978) of the successful use of topical mechlorethamine hydrochloride in Hallopeau's acrodermatitis prompts me to suggest that intramuscular triamcinolone acetonide should always be tried in this disorder. It is highly effective against all the manifestations of inverse psoriasis, including this one. A single dose of 60 mg, deep into the buttock, may be safely followed by a second injection within a week or two if the response is disappointing; a third treatment is unlikely to be needed. Relapses, mysteriously, are not common, at least in lesions that involve only one digit. Side effects, barring disturbances of the menstrual cycle, are virtually nil, as one would expect from such a small total dose.
Nonproprietary Name and Trademark of Drug
Triamcinolone acetonide—Kenalog 40.
Arnold HL. Treatment of Hallopeau's Acrodermatitis With Triamcinolone Acetonide. Arch Dermatol. 1978;114(6):963. doi:10.1001/archderm.1978.01640180093030