Korean J Dermatol.  2005 Feb;43(2):239-243.

A Case of SAPHO Syndrome in a Palmoplantar Pustulosis Patient

• Kwon OE
• Kim HS
• Sim SJ
• Song KH
• Kim KH

Abstract

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.

Keyword

SAPHO; Palmoplantar pustulosis; Psoriatic arthritis; Seronegative spondyloarthropathy

MeSH Terms

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
HLA-B27 Antigen