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

A 66-year-old woman was transferred to our hospital due to her right breast cancer. Preoperative breast MRI shows 1.9 cm malignancy on her right breast (cT1N0M0) and incidentally found osteosclerotic change of left coststernoclavicular region. Bone scintigraphy showed hot uptake and the possibility of bone metastasis was not excluded. However, because the bone metastasis is not common in early stage cancer and the costosternoclavicular region is not common site, other possibility should be considered. SAPHO syndrome can be diagnosed even in the absence of dermatosis when there is an axial or appendicular osteitis and hyperostosis, especially in costosternoclavicular region. Though breast imaging specialists are not accustomed to this disease entity, awareness and diagnosis of the SAPHO syndrome can help differentiate bone metastasis.
Acquired Hyperostosis Syndrome* ; Aged ; Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Humans ; Hyperostosis ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Osteitis ; Radionuclide Imaging ; Skin Diseases ; Specialization

SAPHO syndrome is a rare inflammatory, pseudoinfectious disease. Initially it was an acronym for Syndrome Acne Pustulosis Hyperostosis Osteitis, and the meaning of S was later changed to synovitis. It occurs predominantly in children and adults and is not common over 60 years. The most common clinical presentation is osteoarticular involvement at the anterior chest wall and skin manifestations may be evident, but it could occur years earlier or develop later. We report on two cases of mother and daughter. A 51-year-old female was diagnosed with SAPHO syndrome with costochondritis and palmoplantar pustulosis. Five years later, her 31-year-old daughter presented with similar skin manifestations of the hand and foot.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Adult ; Child ; Female ; Foot ; Hand ; Humans ; Hyperostosis ; Middle Aged ; Mothers ; Nuclear Family* ; Osteitis ; Psoriasis ; Skin Manifestations ; Synovitis ; Thoracic Wall

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