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Observation
April 2017

Novel Application of High-Dose-Rate Brachytherapy for Severe, Recalcitrant Acrodermatitis Continua of Hallopeau

Author Affiliations
  • 1Department of Dermatology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
  • 2Division of Dermatology, The University of Arizona College of Medicine, Tucson
  • 3Division of Brachytherapy, Department of Radiation Oncology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
JAMA Dermatol. 2017;153(4):331-332. doi:10.1001/jamadermatol.2016.5142

We present a case of severe acrodermatitis continua of Hallopeau (ACH) for which traditional medical therapies had failed or could not be administered owing to contraindications. However, the condition showed marked improvement with high-dose-rate (HDR) brachytherapy.

A woman in her 70s with hypertension, chronic kidney disease, and a history of invasive breast cancer presented with a 4-year history of recalcitrant ACH. Physical examination revealed erythematous, scaly plaques with fissuring and deep-seated pustules of the bilateral second and third fingers along with onychauxis and onycholysis of the involved fingernails (Figure, A).

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