Showing papers on "Palmoplantar pustulosis published in 2015"
TL;DR: An overview of the radiological appearances of SAPHO syndrome is provided, focusing on the magnetic resonance imaging findings of vertebral involvement, and relevant clinical and pathological features that assist early diagnosis are presented.
Abstract: The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome includes a group of chronic, relapsing, inflammatory musculoskeletal disorders with similar manifestations, in particular synovitis, hyperostosis, and osteitis, which may or may not be associated with neutrophilic skin eruptions such as palmoplantar pustulosis and acne conglobata. The syndrome occurs at any age, can involve any skeletal site, and its imaging appearances are variable, depending on the stage/age of the lesion and imaging method. The diagnosis is difficult if there is no skin disease. Awareness of the imaging appearances, especially in the spine, may help the radiologist in avoiding misdiagnosis (e.g., infection, tumor) and unnecessary invasive procedures, while facilitating early diagnosis and selection of an effective treatment. In this article, we provide an overview of the radiological appearances of SAPHO syndrome, focusing on the magnetic resonance imaging findings of vertebral involvement, and present relevant clinical and pathological features that assist early diagnosis.
44 citations
TL;DR: Regional LyP may be more indolent than classic LyP, and it can accompany with PEH as observed with classic Lyp, and the condition may remit spontaneously without treatment.
Abstract: soles as well as on the face, scalp and anogenital area. A CD30+LyP associated with keratoacanthoma or pesudocarcinoma changes are described in literature. PEH might be associated with many different conditions, mostly benign but rarely with some malignant conditions. Association of PEH with cutaneous lymphomas has occasionally been reported in the literature. Our patient raised PEH as she was diagnosed regional LyP 9 years later, which confined with a CD30-positive lymphomatoid infiltration induced a PEH. More cases are need to reveal the special relationship between CD30-positive and epidermal proliferation. To our knowledge, only a few cases of regional LyP, such as in trunk, arms, thighs or a cheek, have been reported. Interestingly, that is the first time we observed regional Lyp accompanied with PEH epidermal changes. There are no guidelines for the treatment of regional LyP. In some patients, a spontaneous resolution of lesions has been reported, whereas in other cases, topical steroids, injections of gamma-interferon, oral minocycline, radiation therapy and antihistamines have been used with various degrees of success. In our experience, we treated the patient with topical nitrogen mustard lotion and subcutaneous injection of a-2b Interferon, and the lesions resolved completely in 2 months. In conclusion, regional LyP may be more indolent than classic LyP, and it can accompany with PEH as observed with classic LyP. The condition may remit spontaneously without treatment. However, there is a potential risk to develop lymphoma. We suggest that life-long follow-up is necessary. Topical nitrogen mustard and subcutaneous injection of a-2b Interferon is good therapeutic regimen in our experience.
22 citations
TL;DR: A 43-year-old woman with a 3-year history of headache, fever, and swelling of the forehead, presented to hospital and SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome with associated hypertrophic pachymeningitis was diagnosed.
16 citations
TL;DR: After administration of cefcapene pivoxil hydrochloride (CFPN-PI), a third-generation cephalosporin, the swelling and sternoclavicular joint pain were promptly reduced and dramatically improved in all 3 cases.
Abstract: Pustulosis palmaris et plantaris or palmoplantar pustulosis (PPP) is a refractory pustular eruption of the palms and soles with unknown etiology. In addition to skin lesions, PPP patients may present with severe joint pain and pustulotic arthro-osteitis (PAO), especially of the sternoclavicular joint. PAO is sometimes regarded as a variant of synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Hence, macrolide and tetracycline antibiotics are used for the treatment of PPP with PAO. We report 3 cases of PPP with PAO that did not improve upon administration of macrolide antibiotics with NSAIDs. After administration of cefcapene pivoxil hydrochloride (CFPN-PI), a third-generation cephalosporin, the swelling and sternoclavicular joint pain were promptly reduced and dramatically improved in all 3 cases. We review the conventional antibiotic treatments used currently and propose CFPN-PI as a potentially new therapy for PPP or PPP + PAO.
12 citations
TL;DR: Analysis of climatic predictions for extrinsic incubation of Dirofilaria in the United Kingdom and the emergence of a zoonotic mosaic shows support for the view that climatic forecasts are likely to be biased towards the positive in the coming years.
Abstract: animal dirofilariasis: the emergence of a zoonotic mosaic. Clin Microbiol Rev 2012; 25: 507–44. 3 Muro A, Genchi C, Cordero M. Human dirofilariasis in the European Union. Parasitol Today 1999; 15: 386–9. 4 Ratnatunga N,Wijesundera MS. Histopathological diagnosis of subcutaneous Dirofilaria repens infection in humans. Southeast Asian J TropMed Public Health 1999; 30: 375–8. 5 Medlock JM, Barrass I, Kerrod E et al. Analysis of climatic predictions for extrinsic incubation of Dirofilaria in the United Kingdom. Vector Borne Zoonotic Dis 2007; 7: 4–14.
11 citations
TL;DR: The experience supports the utility of isotretinoin as a potential therapeutic alternative, which may be particularly beneficial in patients who are poor candidates for or unable to tolerate acitretin therapy.
Abstract: Importance: Variably considered as a localized subtype of pustular psoriasis, palmoplantar pustulosis (PPP) is commonly treated with topical steroids, acitretin, and local phototherapy with oral or topical psoralen (PUVA). The utility of acitretin for PPP is limited by adverse effects such as myalgias and an extended risk of teratogenicity in female patients. Isotretinoin is a more tolerable retinoid with a shorter teratogenic window, but to date its effectiveness in PPP has not been reported. Herein we present two patients with PPP who responded well to isotretinoin treatment. Observations: Two patients with PPP refractory to topical therapies were started on acitretin. Both patients developed adverse effects (including headache, myalgias, and mood alterations) leading to acitretin discontinuation. Isotretinoin monotherapy was started in one patient resulting in significant clearing of palmar plaques and scale, and the addition of isotretinoin to UVA therapy resulted in near-complete clearing of recalcitrant plantar plaques in the second patient. Conclusions and Relevance: Acitretin represents an important treatment for PPP, but is limited by adverse effects and extended teratogenicity. Our experience supports the utility of isotretinoin as a potential therapeutic alternative, which may be particularly beneficial in patients who are poor candidates for or unable to tolerate acitretin therapy.
9 citations
TL;DR: SAPHO syndrome is associated with inflammatory cytokine release and global neutrophil activation, and the fact that elevated levels of TNF-a have been found in the biopsies of these patient’s articular bone have led to the treatment of refractory patients with anti-TNF- a drugs.
Abstract: The acronym SAPHO was coined in 1987 to describe a rare syndrome with the following clinical characteristics: Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis. Skin manifestations are multiple: severe acne, palmoplantar pustulosis, hidradenitis suppurativa, or several psoriasis patterns. The most common form of articular manifestation is symmetrical and bilateral arthritis of the sternoclavicular joints. There are three diagnostic criteria: chronic recurrent multifocal osteomyelitis with or without dermatological manifestations; acute or chronic sterile arthritis associated with severe acne, pustular psoriasis, or palmoplantar pustulosis; and sterile osteitis in the presence of one of the skin manifestations. Both the dermatological and articular symptoms appear as outbreaks, and they can both occur simultaneously or separated by variable time intervals. The etiology of this syndrome is unknown. Some authors have stated that this arthropathy is due to a reaction to Propionibacterium acnes or other microorganisms that have low infectiveness in genetically predisposed patients, whereas other authors believe that it is attributed to a seronegative spondyloarthropathy. The analysis may show an increased level of acute phase reactants. HLA-B27 may be positive, while rheumatoid factor and anti-CCP2 are negative. No autoantibodies have been found. SAPHO syndrome is associated with inflammatory cytokine release and global neutrophil activation. Tumor necrosis factor (TNF)-a productions could play a role in initiating inflammation and polymorphonuclear neutrophil infiltration in this patient group. The fact that elevated levels of TNF-a have been found in the biopsies of these patient’s articular bone have led to the treatment of refractory patients with anti-TNF-a drugs.
8 citations
TL;DR: SAPHO syndrome should be considered in patients presenting osteoarticular pain, particularly involving the anterior chest wall and/or spine, and neutrophilic skin lesions.
Abstract: Key teaching points • Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is characterized by distinctive osteoarticular manifestations and a spectrum of neutrophilic dermatoses. • The most common dermatologic manifestations include palmoplantar pustulosis, acne conglobata, and acne fulminans. • SAPHO syndrome should be considered in patients presenting osteoarticular pain, particularly involving the anterior chest wall and/or spine, and neutrophilic skin lesions.
4 citations
TL;DR: A case report and review of the literature shows that haploinsufficiency for AAGAB causes clinically heterogeneous forms of punctate palmoplantar keratoderma, with Hyperkeratosis lenticularis perstans, or Flegel disease, with palmoplants involvement.
Abstract: 1 Buschke A, Fischer W. Keratodermia maculosa disseminata symmetrica palmaris and plantaris. Ikonographia Dermatologica 1910; 5: 183–192. 2 Punctate keratoses of the palms and soles. In: James W, Berger T, Elston D, eds. Andrews Diseases of the Skin: Clinical Dermatology, 10th edn. Philadelphia: Saunders, 2006; 212–213. 3 Pohler E, Mamai O, Hirst J et al. Haploinsufficiency for AAGAB causes clinically heterogeneous forms of punctate palmoplantar keratoderma. Nat Genet 2012; 44: 1272–1276. 4 Kong MS, Harford R, O’Neill JT. Keratosis punctata palmoplantaris controlled with topical retinoids: a case report and review of the literature. Cutis 2004; 74: 173–179. 5 Fernandez-Crehuet P, Rodriguez-Rey E, Rios-Martin JJ, Camacho FM. Hyperkeratosis lenticularis perstans, or Flegel disease, with palmoplantar involvement. Actas Dermosifiliogr 2009; 100: 157–159.
2 citations
1 citations
Patent•
20 May 2015
TL;DR: The linimentum for treating palmoplantar pustulosis is described in this paper, which comprises the following raw materials in parts by weight: 100-10 parts of rhizoma dioscoreae hypoglaucae, 100- 10 parts of radix smilacis glabrae, 100 -10 parts radix sophorae flavescentis, cortex dictamni, cortex kochiae, cortex phellodendri, talcum, and fructus forsythia.
Abstract: The invention relates to linimentum for treating palmoplantar pustulosis, and a preparation method thereof. The linimentum comprises the following raw materials in parts by weight: 100-10 parts of rhizoma dioscoreae hypoglaucae, 100-10 parts of rhizoma smilacis glabrae, 100-10 parts of radix sophorae flavescentis, 100-10 parts of cortex dictamni, 100-10 parts of fructus kochiae, 100-10 parts of cortex phellodendri, 100-10 parts of talcum, 100-10 parts of fructus forsythia and 3000-200 parts of distilled water. The preparation method comprises the following steps: grinding rhizoma dioscoreae hypoglaucae, rhizoma smilacis glabrae, radix sophorae flavescentis, cortex dictamni, fructus kochiae, cortex phellodendri, talcum, and fructus forsythiae into fine powder, performing high-pressure sterilization and adding distilled water and fully stirring evenly, subpacking into plastic bottles, thus obtain the linimentum for treating palmoplantar pustulosis. In 104 clinical treatment cases, 93 cases are cured, 11 cases shows efficacy.
01 Jan 2015
TL;DR: It is concluded that palmoplantar pustulosis (PPP) might be caused by olfactory cleft inflammation, and administration of intranasal steroid drops helped restore healthy skin.
Abstract: We present a case of palmoplantar pustulosis (PPP) secondary to olfactory cleft inflammation in a 65-year-old man. He had a 10-year history of PPP. Computed tomography showed an abnormal intensity that corresponded to chronic inflammatory sinusitis in the right maxillary and ethomoidal sinuses, and obstruction of the olfactory cleft. After administration of intranasal steroid drops, the olfactory cleft inflammation improved and healthy skin was restored. Discontinuing this treatment resulted in worsening of the skin lesions 3 times over 3 years. Although the chronic inflammatory sinusitis persisted, the olfactory cleft inflammation improved. Therefore, we conclude that PPP might be caused by olfactory cleft inflammation.