Acrodermatitis continua of hallopeau

A 55 years old gentleman with long history of chronic plague psoriasis, had the following hand appearances.

At a glance, I thought it was psoriatic athritis mutilans, as there were deformities over the distal phalanges. It was characterized by fixed flexion deformity of the distal interphalangeal joints with obvious distal phalanges resorption.

However, my friend told me, it was Acrodermatitis continua of Hallopeau.

Below are five pictures I downloaded from the internet, but they look quite different:










Here is a picture of arthritis multilans:

Acrodermatitis continua of Hallopeau is a chronic skin disorder characterized by recurrent sterile, pustular eruptions of the digits with marked involvement of the nail beds. The intermittent pustulations may lead to atrophy, onichodystrophy and even osteolysis.

More links:
www.vgrd.org
Dermatology:Case report (PDF)
Dermatology Online Journal