Acrodermatitis Continua

Synonym: Dermatitis repens.

It is a chronic, slowly progressive and persistent pyogenic dermatitis occurring on the hands, less so, on the feet and other parts of the body. It usually complicates suppurative paronychia or an injury on a finger. It starts as a bulla or a pustule, which spreads peripherally by extension of an undermined epidermal border. New lesions arise by contiguity, or at some distance from the initial lesion. Rarely does it become disseminated or generalized. This condition differs from pustular bacteride which is characterized by bilaterally symmetrical pustular eruption on the palms and the soles accompanying an active pyogenic focus.

Causes of Acrodermatitis Continua
The course is chronic with acute exacerbations from time to time. It is regarded as being caused by Staphylococcus aureus. Underlying monilial and tinea infections must be excluded. In every case, a thorough search should be made for an active focal sepsis.

Treatment of Acrodermatitis Continua
The treatment is unsatisfactory. It consists in cleaning up and exposing the peripheral edge, potassium permanganate soaks, and painting the lesions with 5 per cent aqueous silver nitrate once only. This is followed by the local application of bacitracin and hydrocortisone ointment twice a day. The ointment should be rubbed meticulously into the edges of the lesion to obtain good results. In resistant cases, superficial X-ray therapy and autogenous vaccine may be tried.

Diagnosis of Acrodermatitis Continua
Acrodermatitis continua must be distinguished from acrodermatitis enteropathica which is characterized by persistent eczematoid skin lesions on the hands and feet, baldness, a dull, inelastic skin, a stunted growth coupled with a sallow complexion; it is accompained by chronic intestinal infection. It commonly affects infants and children. The condition responds specifically to di-idoquin (2 TDS), and zinc sulphate (100-150 mg daily).