[Vertebral and thoracic osteoarticular manifestations in palmoplantar pustulosis]

Two cases of inflammatory joint disease during attacks of aseptic palmo-plantar pustulosis are reported. Both patients had vertebral involvement: disco-vertebral erosions at several levels in one case and spondylitis and intersomatic ossification in the other. One patient also had sacroiliitis and involvement of the anterior thoracic skeleton (costoclavicular joints, costal cartilages ans xiphoid) confirmed by bone scintigraphy. The relation between this cutaneous-articular syndrome and other inflammatory joint diseases, especially ankylosing spondylitis and psoriatic arthropathy are discussed. The very unusual involvement of the anterior thoracic skeleton, the coexistence of aseptic palmo-plantar pustulosis and absence of antigens HLA B27, B13 and B17 suggest a similarity to the pustular osteoarthritis recently described by Japanese workers who grouped this condition with other spondylarthropathies.