[Osteoarticular manifestations of palmoplantaris pustulosis. A prospective study of 15 cases]

Between 1986 and 1989, we conducted a clinical, biochemical, radiological and scintigraphic prospective study of 15 patients (8 men, 7 women) with histologically proven palmoplantar pustulosis. In 70 percent of the cases the time interval between the first cutaneous and the first osteoarticular signs was 2 years. Anterior thoracic clinical manifestations were frequent. The joints and the numbers of patients involved were: sternoclavicular (12), manubriosternal (6), sternocostal (5), intervertebral (11), sacroiliac (6) and peripheral (10). Two patients had osteitis. The clinical, radiological and scintigraphic findings, as well as the distribution of these arthropathies over the anterior thorax (i.e. over a sternocostoclavicular complex with numerous ligaments), suggest a preference for entheses. Despite the absence of link with the HLA B27 antigen, the frequent association with pelvic and spinal lesions indicate that the articular disease of palmoplantar pustulosis is a spondyloarthropathy.