Dual IL-17A/F Blockade for Acrodermatitis Continua of Hallopeau: A Clinical Response to Bimekizumab

Acrodermatitis continua of Hallopeau (ACH) is a rare, localized variant of pustular psoriasis that primarily affects the distal digits and nail apparatus, often presenting with recurrent pustules, nail dystrophy, and significant functional impairment. Due to its rarity and chronic relapsing course, ACH is notoriously difficult to treat, and standardized treatment guidelines are lacking. We present the case of a 67-year-old male with ACH who failed multiple therapies, including corticosteroids, topical tapinarof, and oral deucravacitinib, before achieving rapid and sustained improvement with bimekizumab, a monoclonal antibody targeting interleukin-17A and IL-17F. Within one month of initiating bimekizumab, the patient experienced marked clinical improvement in both skin lesions and joint pain, with continued progress allowing him to return to work. This case highlights the potential utility of dual IL-17A/F inhibition in neutrophil-dominant pustular conditions such as ACH. As more case reports document favorable outcomes, bimekizumab may emerge as a valuable treatment option for patients with refractory ACH, offering targeted cytokine blockade in a condition with few effective therapies.  .