DOI: https://doi.org/10.36347/sasjm.2026.v12i05.033

Pages: 554-556

Acrodermatitis continua of Hallopeau (ACH) is a rare chronic variant of pustular psoriasis characterized by sterile pustules affecting the distal extremities. We report an unusual case of a 75-year-old woman presenting with acropustular lesions evolving for 1 year, associated with distal onychodystrophy. Clinical examination revealed erythematous plaques with pustular eruptions involving the fingers and toes, with remarkable sparing of the right hand and the left middle finger, corresponding to the sites where the patient had continuously worn a silver bracelet and a silver ring for more than 50 years. Histopathologic examination demonstrated hyperkeratosis, parakeratosis, acanthosis, neutrophilic infiltrates, and spongiosis, supporting the diagnosis of ACH. Treatment with Acitretin resulted in significant clinical improvement. This observation suggests a possible locoregional anti-inflammatory protective effect of silver jewelry. Similar findings have previously been described with other metallic ornaments in psoriatic arthritis and nail psoriasis. Recent studies on silver- and gold-based nanoparticles further support the anti-inflammatory potential of metallic biomaterials in psoriasis. To our knowledge, this is the first reported case highlighting a possible protective role of silver jewelry in pustular psoriasis.