SAPHO

Definition

 

Clinical syndrome characterised by

 

Synovitis

Acne

Pustulosis

Hyperostosis

Osteitis

 

Aetiology

 

Unknown

- high prevalence of HLA B-27 antigen

- similarities to seronegative spondyloarthropathy 

 

Four types

 

1. Severe acne or hidradenitis suppuritiva with osteoarticular disease

 

2. Palmoplantar pustulosis with osteoarticular disease

 

3. Axial or appendicular hyperostosis +/- pustular dermatosis (sternocalvicular hyperostosis)

 

4. Disease similar to CRMO

 

Symptoms

 

Sternoclavicular hyperostosis

Sterile inflammatory lesions

Hyperostosis & osteitic lesions may be similar to malignant conditions

Synovitis does not usually lead to bony erosions

 

Management

 

Analgesics & oral anti-inflammatories

 

Prognosis

 

Favourable

- often protracted course with intermittent relapses & remissions without serious disability