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Erschienen in:
19.02.2020 | Clinical Practice: Clinical Image
SAPHO Syndrome from Hidradenitis Suppurativa
Erschienen in: Journal of General Internal Medicine | Ausgabe 4/2020
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A 36-year-old man with 10 years of hidradenitis suppurativa (HS) presented with worsened HS and joint pain in both hands after stopping adalimumab therapy 1 year earlier. Examination revealed a temperature of 38.2 °C, HS lesions draining purulent material over the chest (Fig. 1), and erosions in bilateral proximal interphalangeal joints (Fig. 2). His white blood cell count was 21,000/μL and hand radiographs were consistent with inflammatory arthropathy. He received a diagnosis of hidradenitis suppurativa with superimposed cellulitis in the setting of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. Treatment included antibiotics and wound care. He resumed adalimumab and started doxycycline for long-term suppressive therapy.1 He failed to improve, and his treatment was escalated from adalimumab to secukinumab.
Figure 1
Patient’s chest with nodules and sinus tracts draining purulent material.
Figure 2
Hand radiograph. Left hand: erosions and periosteal reaction centered at the 4th proximal interphalangeal joint (arrow) with soft tissue swelling.
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