Yeungnam Univ J Med.  2013 Jun;30(1):55-57.

A Case of Successful Treatment of Refractory Synovitis Acne Pustulosis Hyperostosis Osteitis (SAPHO) Syndrome with Adalimumab

• Yoo JT
• Kim YH
• Jung SM
• Kwon SC
• Ryu SM
• Ha JO
• Lee JW

Abstract

Synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome is a rare disease that involves the skin, bones and joints. It is thought to be caused by infection with low-toxicity bacteria and to be the result of reactive infectious osteitis. However, this hypothesis has not yet been clearly established. New SAPHO syndrome treatment methods are needed because the disease does not respond to treatment in many cases. In this paper, a case is reported of SAPHO syndrome with pain in the acromioclavicular joint and with squamous and pustular macules on the palms and soles. First, the patient was treated with aceclofenac, prednisolon and sulfasalazine for two weeks. However, the symptoms were not relieved, so methotrexate and pamidronate were added to the treatment. Since no improvement was seen after four weeks of treatment, adalimumab was prescribed. The skin lesions were relieved two weeks later, and the bone pain and arthralgia, four weeks later. No recurrence or adverse effects were observed at the 22-week follow-up.

Keyword

SAPHO syndrome; Treatment; Adalimumab

MeSH Terms

Acne Vulgaris
Acquired Hyperostosis Syndrome
Acromioclavicular Joint
Antibodies, Monoclonal, Humanized
Arthralgia
Bacteria
Diclofenac
Diphosphonates
Follow-Up Studies
Humans
Hyperostosis
Joints
Methotrexate
Osteitis
Rare Diseases
Recurrence
Skin
Sulfasalazine
Synovitis
Adalimumab
Antibodies, Monoclonal, Humanized
Diclofenac
Diphosphonates
Methotrexate
Sulfasalazine