Korean J Dermatol.  2019 Mar;57(3):145-148.

A Case of SAPHO Syndrome Associated with Lytic Bone Lesions Resembling Metastases

• Choi MS
• Seong GH
• Park MJ
• Park M
• Park BC
• Kim MH
• Hong SP

Abstract

SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome includes a variety of inflammatory bone disorders associated with dermatologic pathology. A 57-year-old female presented with pustulosis on both hands that had persisted for several months. She also had lower back pain without trauma history. On physical examination, tenderness on her lower back and left anterior chest wall pain were found, and claudication was observed. Radiological studies including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)-CT showed endplate lytic changes in her spine, a focal hypermetabolic lesion in a left rib, and costochondral junction. These findings raised doubt on the presence of metastatic bone lesions, and there was no indication for primary cancer after a complete medical checkup. Palmoplantar pustulosis was well controlled by treatment with acitretin. The osteitis associated with SAPHO syndrome usually presents as osteosclerosis, while reports on osteolytic lesions are rare. We report herein a rare case of SAPHO syndrome associated with bone lesions resembling bone metastasis.

Keyword

Palmoplantar pustulosis; SAPHO syndrome; Osteolytic lesion

MeSH Terms

Acitretin
Acne Vulgaris
Acquired Hyperostosis Syndrome*
Female
Hand
Humans
Hyperostosis
Low Back Pain
Magnetic Resonance Imaging
Middle Aged
Neoplasm Metastasis*
Osteitis
Osteosclerosis
Pathology
Physical Examination
Positron-Emission Tomography
Ribs
Spine
Thoracic Wall
Acitretin