Arthropathy associated with palmoplantar pustulosis

Area of Science:

• Dermatology
• Rheumatology
• Immunogenetics

Background:

• Palmoplantar pustulosis (PPP) is a chronic inflammatory skin condition.
• Rheumatic complaints are sometimes observed in patients with PPP.
• The genetic associations of PPP, particularly with human leukocyte antigen (HLA) types, require further investigation.

Purpose of the Study:

• To investigate the prevalence of rheumatic complaints in patients diagnosed with palmoplantar pustulosis.
• To identify potential associations between PPP and specific HLA antigens.

Main Methods:

• A survey of 170 patients with palmoplantar pustulosis was conducted.
• Data collected included family history, dermatological and rheumatological examinations, and radiography for suspected joint involvement.
• Screening for active chest-wall symptoms using scintigraphy and HLA antigen typing were performed.

Main Results:

• Twenty-five patients (14.7%) reported rheumatic complaints, with anterior chest-wall involvement (15 patients), sacroiliitis (6 patients), and peripheral arthropathy (11 patients) being common.
• A high incidence of the HLA-B27 antigen was documented in 32% of patients, a finding similar to that observed in psoriatic arthritis.
• No significant association was found with other HLA antigens commonly associated with psoriasis (HLA-B13, -17, -37, CW6).

Conclusions:

• Rheumatic conditions, particularly anterior chest-wall involvement and arthropathy, are common in patients with palmoplantar pustulosis.
• The strong association with HLA-B27 suggests a potential shared immunogenetic pathway between PPP and spondyloarthropathies.
• Further research is warranted to elucidate the relationship between PPP, rheumatic diseases, and specific genetic markers.