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Pustulotic arthroosteitis and chronic recurrent multifocal osteomyelitis in children. Report of three cases
J P Huaux1, W Esselinckx, J J Rombouts
1Department of Orthopedic Surgery, Saint-Luc University Hospital, Louvain University, Brussels, Belgium.
Insights
We report on three children with palmoplantar pustulosis and chronic recurrent multifocal osteomyelitis affecting bones like the clavicle and fibula. This highlights a rare syndrome linking these conditions in pediatric cases.
Area of Science:
- Pediatric rheumatology
- Dermatology
- Orthopedics
Background:
- Pustulosis palmaris et plantaris (PPP) is a chronic skin condition.
- Chronic recurrent multifocal osteomyelitis (CRMO) is a non-bacterial osteomyelitis affecting children.
- The association between PPP and CRMO is rarely described.
Observation:
- Three pediatric patients presented with PPP.
- Two patients had CRMO in the clavicle and inflammatory sacroiliitis.
- The third patient had CRMO in the distal fibula and metatarsals.
Findings:
- The described cases link arthrosteitis and CRMO syndrome with PPP.
- This suggests a potential systemic inflammatory process connecting skin and bone manifestations.
- The specific bone locations observed were clavicle, distal fibula, and metatarsals.
Implications:
- Recognizing this association is crucial for accurate diagnosis and management of children with PPP and bone pain.
- Early identification may prevent long-term morbidity associated with CRMO.
- Further research is warranted to elucidate the underlying pathophysiology of this syndrome.
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.