Pustulotic Arthro-osteitis Improved with Anti TNF-α Inhibitor
- Author:
Hae Seok PARK
1
;
Jong Hoon KIM
;
Hye Won KIM
;
Soo Chan KIM
Author Information
1. Department of Dermatology, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea. Kimsc@yuhs.ac
- Publication Type:Case Report
- Keywords:
Pustulotic arthro-osteitis;
Anti-TNF-α inhibitor
- MeSH:
Arthralgia;
Biopsy;
Cyclosporine;
Diagnosis;
Etanercept;
Humans;
Joints;
Middle Aged;
Neutrophils;
Osteitis;
Physical Examination;
Radionuclide Imaging;
Skin;
Skin Manifestations;
Sternoclavicular Joint;
Steroids
- From:Korean Journal of Dermatology
2019;57(7):378-382
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Pustulotic arthro-osteitis (PAO) is a rare chronic inflammatory disorder characterized by inflammatory osteitis of the sternoclavicular joint and palmoplantar pustulosis. Here, we report a case of PAO that was successfully treated with a TNF-α inhibitor. A 45-year-old man presented with a 3-month history of pustular eruption on the palms and soles. Physical examination showed multiple erythematous papulopustules on the palms, back, and left shin, accompanied by sternoclavicular joint swelling and tenderness. Skin biopsy showed intraepidermal pustules filled with neutrophils on the palm. Bone scintigraphy revealed increased uptake in the bilateral sternoclavicular and other axial joints. Based on these findings, we made the diagnosis of PAO. Even after 6-month treatment of oral steroids and cyclosporine, skin manifestations insufficiently improved, so etanercept therapy was started. Complete clearance of skin lesions and joint pain were achieved after 3 months of etanercept therapy.
