A Case of SAPHO Syndrome Associated with Lytic Bone Lesions Resembling Metastases
- Author:
Mi Soo CHOI
1
;
Gi Hyun SEONG
;
Myeong Jin PARK
;
Minkee PARK
;
Byung Cheol PARK
;
Myung Hwa KIM
;
Seung Phil HONG
Author Information
1. Department of Dermatology, College of Medicine, Dankook University, Cheonan, Korea. zamoo97@naver.com
- Publication Type:Case Report
- Keywords:
Palmoplantar pustulosis;
SAPHO syndrome;
Osteolytic lesion
- MeSH:
Acitretin;
Acne Vulgaris;
Acquired Hyperostosis Syndrome;
Female;
Hand;
Humans;
Hyperostosis;
Low Back Pain;
Magnetic Resonance Imaging;
Middle Aged;
Neoplasm Metastasis;
Osteitis;
Osteosclerosis;
Pathology;
Physical Examination;
Positron-Emission Tomography;
Ribs;
Spine;
Thoracic Wall
- From:Korean Journal of Dermatology
2019;57(3):145-148
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome includes a variety of inflammatory bone disorders associated with dermatologic pathology. A 57-year-old female presented with pustulosis on both hands that had persisted for several months. She also had lower back pain without trauma history. On physical examination, tenderness on her lower back and left anterior chest wall pain were found, and claudication was observed. Radiological studies including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)-CT showed endplate lytic changes in her spine, a focal hypermetabolic lesion in a left rib, and costochondral junction. These findings raised doubt on the presence of metastatic bone lesions, and there was no indication for primary cancer after a complete medical checkup. Palmoplantar pustulosis was well controlled by treatment with acitretin. The osteitis associated with SAPHO syndrome usually presents as osteosclerosis, while reports on osteolytic lesions are rare. We report herein a rare case of SAPHO syndrome associated with bone lesions resembling bone metastasis.
