Etiology and pathogenesis: Unclear, some believe it is related to bacterial infection or infected lesions in the body, others believe it is a type of pustular psoriasis. Clinical manifestations: Prevalent in middle age, with no difference in incidence between the sexes. The disease usually begins in the perinail area of the fingers, occasionally in the toes, and is often preceded by a traumatic infection, resembling nail fungus, followed by the appearance of numerous small pustules or blisters that break down, erode, and crust. After the scab is removed, erythema remains, followed by new pustules, which may fuse into a pus lake, and so on repeatedly, and gradually expand to the whole finger (toe) and the back of the hand and foot, with mild itching, burning pain, the development of slow, prolonged for many years, can cause nail atrophy and fall off, finger (toe) bone resorption, hand and foot deformity. The tongue and cheek mucosa may also be involved, with erythema, erosion, or map tongue. A few develop into pancytosis, with erythema and small pustules on the extremities and trunk, accompanied by systemic symptoms such as high fever, chills and arthralgia, and death may occur due to secondary infection and systemic failure. Diagnostic criteria: 1. Repeated pustules and erosions after trauma to the ends of fingers (toes), gradually spreading upward, progressing slowly, may have mucosal damage, a few generalized throughout the body. 2.Histopathology: spongy pustules with neutrophils in the superficial layer of epidermis. 3, confined to the hands and feet need to be distinguished from palmoplantar pustulosis and dermatitis and eczema with secondary infection, and the generalized form should be distinguished from herpes-like pustulosis and generalized pustular psoriasis. Drug treatment: 1. Search for infected lesions and give appropriate treatment. 2.Tetracycline 0.5-1g/d, divided into 2 doses, for 1-3 months, effective in some cases, but often relapse soon after stopping. 3.Tetracycline can inhibit leukocyte chemotaxis and stabilize lysosomal membrane, reduce tissue damage, and have immunosuppressive effects. It is reported in China that this drug is effective in the treatment of pancystic continuous acrodermatitis with glucocorticoids, and the fever quickly subsides and the pustules begin to subside on the fifth day. 4.Glucocorticoid is used for pancytopenia, prednisone 40mg/d, can be combined with other drugs, some cases can be temporarily effective. 5.Avea ester 50mg/d, or Avea 20-30mg/d, orally, effective in some cases, this drug can work in several ways, including promoting the epidermis to return to normal and make the dermatitis inflammatory infiltration dissipate. 6, PUVA (photochemotherapy) can inhibit the occurrence of new pustules, and can be used in combination with Avia. 7, local treatment, the limited type can use creams or ointments containing antibiotics and glucocorticoids, the use of airtight bandages, continuous treatment for several weeks, can make the course of the disease temporary relief. Topical tar preparations also have certain efficacy. In addition, local irradiation with superficial X-rays or radionuclides is effective in some cases.