Showing papers on "Palmoplantar pustulosis published in 1988"

Palmoplantar pustulosis and sternocostoclavicular arthro-osteitis.

Abstract: Seventeen patients with shoulder pain and radiographic involvement of the sternoclavicular or sternocostal joints, or both, are described. Eleven of these patients also had palmoplantar pustulosis. Histological examination of the joints showed chronic and subacute inflammation, increased osteoblastic activity, and cartilage degeneration. Propionibacterium acnes was cultured in tissue samples from seven of the 15 biopsied patients, a finding at variance with those of previous reports. The possibility that sternoclavicular arthro-osteitis is of infectious origin should be the subject of further investigation. Non-steroidal anti-inflammatory drugs (NSAIDs) may provide pain relief, possibly owing to their inhibitory action on osteoblasts. In cases of severely restricted movement or severe pain resection of the medial clavicle may be considered.

Acitretin and etretinate in the treatment of palmoplantar pustulosis: a double-blind comparative trial.

Abstract: SUMMARY Sixty patients with palmoplantar pustulosis were treated in a double-blind trial with either acitretin (etretin, Ro 10–1670) or with etretinate. The study consisted of 4 weeks of therapy with three 10 mg capsules/day followed by 8 weeks of therapy with a varying number of capsules given daily according to therapeutic response. At the end of the 12-week treatment period, the mean number of pustules (± SEM) had decreased from 57.8 (± 8.6) to 3.9 (± 1.6) in the acitretin group and from 57.1 (± 14.1) to 5.7 (± 2.7) in the etretinate group. With regard to influence on erythema, infiltration, scaling, and area involved, similar improvements were obtained in both treatment groups. Adverse reactions of the hypervitaminosis A type were observed with almost the same frequency and severity in both treatment groups. The mean number of 10 mg capsules used daily was comparable in the two groups: 2.82 (range 1.23–4.67) for acitretin and 2.77 (range 1.60–4.82) for etretinate. It can be concluded that acitretin and etretinate do not significantly differ with regard to efficacy and overall safety in the treatment of patients with palmoplantar pustulosis.

Pustulotic arthroosteitis and chronic recurrent multifocal osteomyelitis in children. Report of three cases.

Abstract: We describe 3 children with pustulosis palmaris et plantaris associated with chronic recurrent (multifocal) osteomyelitis, located in the clavicle in 2 patients, and in the distal fibula as well as in several metatarsals in the third. The first 2 children also developed inflammatory sacroiliitis, one with chronic peripheral polyarthritis. These 3 cases represent the arthrosteitis and chronic recurrent multifocal osteomyelitis syndrome associated with palmoplantar pustulosis.

Intra-epidermal accumulation of polymorphonuclear leukocytes in persistent palmoplantar pustulosis during treatment with acitretin.

Abstract: Six patients with persistent palmoplantar pustulosis were treated with acitretin, and the clinical response was compared with the effect on the intra-epidermal accumulation of polymorphonuclear PMN leukocytes. A prompt improvement of pustule formation and subsequently decreased scaling and erythema was seen in all patients. Following discontinuation of therapy, a relapse occurred within 2 weeks. With dosages of 45 or 55 mg/day, the clinical scores were only slightly better than with 25 or 35 mg/day. In patients using 25 mg acitretin a day, the leukotriene B4-induced intra-epidermal accumulation of polymorphonuclear leukocytes was not affected. However, a dosage of 35 mg/day resulted in a significant inhibition of PMN accumulation, dosages of 45 and 55 mg/day causing an even more pronounced inhibition of this process. Although the effect of different dosages of acitretin is not clearly expressed in the severity scores, the dose-dependent effect on PMN chemotaxis in vivo might be of relevance when combination therapies are considered, in order to achieve a complete clinical clearance.

Palmoplantar pustulosis andsternocostoclavi cular arthro-osteitis

Abstract: SUMMARY Seventeen patients withshoulder painandradiographic involvement ofthe sternoclavicular orsternocostal joints, orboth, aredescribed. Eleven ofthese patients also had palmoplantar pustulosis. Histological examination ofthejoints showedchronic andsubacute inflammation, increased osteoblastic activity, andcartilage degeneration. Propionibacterium acneswas cultured intissue samples fromsevenofthe15biopsied patients, afinding atvariance withthose ofprevious reports. Thepossibility that sternoclavicular arthro-osteitis isofinfectious origin should bethesubject offurther investigation. Non-steroidal anti-inflammatory drugs (NSAIDs) may provide painrelief, possibly owingtotheir inhibitory action on osteoblasts. In casesofseverely restricted movementor severepainresection ofthemedial clavicle may be considered.