PMC9709846_01
(A) Patient's fingers at the moment of biopsy in September 2019; histopathology of skin lesion [(B) H&E, 40x scale bar: 50 um; (C) H&E, 40x, scale bar: 10 um] showed moderate acanthosis, diminished granular layer, subcorneal neutrophilic pustules, and spongiosis.
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In the summer of 2019, pustules gradually developed to multiple fingers of her both hands (Figure 1A), she visited our clinic and had a biopsy, bacterial culture was sterile and the pathologic results confirmed the diagnosis of ACH (Figure 1B and C).
Manifestations on the trunk and limbs of the patient before treatment with narrowband ultraviolet B and acitretin (A-E) and after treatment with narrowband ultraviolet B and acitretin (a-e).
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Physical examination revealed widespread erythema and dense pustules on the trunk and limbs (Figure 2A-E). After another two weeks of treatment, the lesions all over her body had totally subsided, leaving only pigmentation (Figure 2a-e).
Manifestations of the fingers and toes before treatment with narrowband ultraviolet B and acitretin (A and B) and after treatment with narrowband ultraviolet B and acitretin (a and b).
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Nails of these fingers and toes were dystrophic and the nail plate were also studded with pustules (Figure 3A and B). Symptoms of fingers and toes also improved (Figure 3a and b).