No abstract available.
Acquired Hyperostosis Syndrome* ; Radionuclide Imaging*

Acquired Hyperostosis Syndrome/surgery* ; Humans ; Tonsillectomy

The term, SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome is an acronym to designate a clinico-radiologic entity with combination of skin, bone, and joint manifestations. We, herein, present a case of SAPHO syndrome in a 27-year-old man with pruritic, localized, crops of deep-seated pustules on both palms and soles for 2 years, and multiple joints pain including anterior upper chest pain for 3 years. Histopathologically, the palm showed a large intraepidermal cavity filled with many neutrophils, and many typical spongiform pustules at the wall of it. Radiographically, the left sternoclavicular joint showed synovitis, osteitis and hyperostosis.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Adult ; Chest Pain ; Humans ; Hyperostosis ; Joints ; Neutrophils ; Osteitis ; Skin ; Sternoclavicular Joint ; Synovitis

We describe two cases of SAPHO syndrome with history of palmoplantar pustulosis and pain on the anterior chest wall and lower back area. The acronym SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome includes a group of disorders characterized by bony lesions commonly involving the anterior chest wall and associated with skin manifestations. The skeletal manifestation is characterized by the association of inflammation and hyperostotic change, in the form of sternocostoclavicular hyperostosis, spondyloarthropathy and chronic recurrent multifocal osteomyelitis. Common cutaneous lesions include palmoplantar pustulosis, pustulotic psoriasis, and severe forms of acne. The pathogenesis remains elusive, but a link with seronegative spondyloarthropathy is probable. To date, the treatment is empirical. Nonsteroidal anti-inflammatory drugs are the first choice, and other drugs including corticosteroid, disease modifying antirheumatic drugs, pamidronate, and infliximab have been tried with some therapeutic benefit. SAPHO syndrome is a condition in the differential diagnosis of infectious or tumorous conditions of the bone. Early and proper diagnosis is important to avoid unnecessary investigations or treatments.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Antirheumatic Agents ; Diagnosis ; Diagnosis, Differential ; Hyperostosis ; Hyperostosis, Sternocostoclavicular ; Inflammation ; Osteomyelitis ; Psoriasis ; Skin Manifestations ; Spine ; Spondylarthropathies ; Thoracic Wall ; Infliximab

We describe two cases of SAPHO syndrome with history of palmoplantar pustulosis and pain on the anterior chest wall and lower back area. The acronym SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome includes a group of disorders characterized by bony lesions commonly involving the anterior chest wall and associated with skin manifestations. The skeletal manifestation is characterized by the association of inflammation and hyperostotic change, in the form of sternocostoclavicular hyperostosis, spondyloarthropathy and chronic recurrent multifocal osteomyelitis. Common cutaneous lesions include palmoplantar pustulosis, pustulotic psoriasis, and severe forms of acne. The pathogenesis remains elusive, but a link with seronegative spondyloarthropathy is probable. To date, the treatment is empirical. Nonsteroidal anti-inflammatory drugs are the first choice, and other drugs including corticosteroid, disease modifying antirheumatic drugs, pamidronate, and infliximab have been tried with some therapeutic benefit. SAPHO syndrome is a condition in the differential diagnosis of infectious or tumorous conditions of the bone. Early and proper diagnosis is important to avoid unnecessary investigations or treatments.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Antirheumatic Agents ; Diagnosis ; Diagnosis, Differential ; Hyperostosis ; Hyperostosis, Sternocostoclavicular ; Inflammation ; Osteomyelitis ; Psoriasis ; Skin Manifestations ; Spine ; Spondylarthropathies ; Thoracic Wall ; Infliximab

Acquired Hyperostosis Syndrome ; therapy ; Combined Modality Therapy ; Humans ; Integrative Medicine ; Male ; Middle Aged

SAPHO syndrome, which has different skin changes and osteoarticular inflammation, is an acronym that stands for synovitis, acne, pustulosis, hyperostosis, and osteitis. Treatment of SAPHO syndrome includes non-steroidal anti-inflammatory drugs (NSAIDs), anti-rheumatic drugs, such as colchicines, corticosteroids and bisphosphonates, and disease-modifying agents. However, the treatment of SAPHO syndrome is controversial because it is a new clinical entity with unclear etiopathogenesis and inadequate clinical studies. We report a case with refractory SAPHO syndrome, which was successfully treated with a tumor necrosis factor (TNF)-alpha blocker.
Acne Vulgaris ; Acquired Hyperostosis Syndrome ; Adrenal Cortex Hormones ; Antirheumatic Agents ; Diphosphonates ; Hyperostosis ; Immunoglobulin G ; Inflammation ; Osteitis ; Receptors, Tumor Necrosis Factor ; Skin ; Synovitis ; Tumor Necrosis Factor-alpha ; Etanercept

SAPHO syndrome is characterized by sternocostoclavicular osteoarthritis and hyperostosis in the anterior chest wall, and skin changes such as palmoplantar pustulosis and acne. Despite the higher frequency of psoriasis in this syndrome, its inclusion in the psoriatic arthropathy spectrum is not yet clearly established to date. According to a familial series of the SAPHO syndrome, both sacroiliac and sternoclavicular joints could be involved. We report a case of SAPHO Syndrome in a palmoplantar pustulosis patient who had on associated osteoarticular manifestation. A 47-year-old woman had been treated for palmoplantar pustulosis for 15 months. Pain and tenderness then developed abruptly on the chest and neck, and multiple erythematous papules and pustules broke our over the whole body. Laboratory tests were negative for serum RA factor and ANA, and positive for HLA-B27. An X-ray showed a hyperostosis, osteolytic and osteosclerotic lesions in the costo-sterno-clavicular junction. 99mTc isotope scan showed the typical "Bull's head sign" in the anterior chest wall due to increased uptake in the manubrium and both sternoclavicular joints.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Arthritis, Psoriatic ; Female ; Head ; HLA-B27 Antigen ; Humans ; Hyperostosis ; Manubrium ; Middle Aged ; Neck ; Osteoarthritis ; Psoriasis ; Skin ; Sternoclavicular Joint ; Thoracic Wall ; Thorax

SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome designates a group of articular and osseous manifestations frequently combined with skin disorders. Its fundamental component is inflammatory, pseudoinfectious, and sterile osteitis. The anterior chest wall is the most frequent localization and all the components of this structure may be involved. Palmoplantar pustulosis, psoriasis, acne conglobata, acne ulcerans, acne fulminans, pyoderma gangrenosum can be associated with the characteristic bone lesions. We report two cases of SAPHO syndrome : A 40-year-old female presented with both buttock pain with hyperostosis, costochondritis, synovitis and pustulosis palmaris and a 23-year-old male presented with migrating polyarthritis with costochondritis, synovitis, acne, pustulosis.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Adult ; Arthritis ; Buttocks ; Female ; Humans ; Hyperostosis ; Male ; Osteitis ; Psoriasis ; Pyoderma Gangrenosum ; Skin ; Synovitis ; Thoracic Wall ; Young Adult

SAPHO syndrome, characterized by synovitis, acne, pustulosis, hyperostosis, and osteitis is rare compared to other spondyloarthropathies. It is also difficult to diagnose, and treatment methods have not yet been fully identified. Approximately 72% of patients are diagnosed with at least one other disease before a final diagnosis of SAPHO syndrome. In addition, SAPHO syndrome is subject to a delayed diagnosis period of 4.5 to 9.1 years. Medications such as non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, and tumor necrosis factor inhibitors are used in treatment of SAPHO syndrome. Bisphosphonate is also used for refractory SAPHO syndrome; however, most reports on this relate to intravenous injection of medication. The authors experienced and subsequently reported on a case involving a patient with SAPHO syndrome accompanied by fracture and infection of the left second finger who was treated with the oral biphosphonate, alendronate.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Alendronate* ; Antirheumatic Agents ; Delayed Diagnosis ; Diagnosis ; Fingers ; Humans ; Hyperostosis ; Injections, Intravenous ; Osteitis ; Spondylarthropathies ; Synovitis ; Tumor Necrosis Factor-alpha