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Four cases of pustulotic arthro-osteitis
1Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
The Journal of Dermatology
|May 12, 1998
Summary
Pustulotic arthro-osteitis presents with anterior chest wall pain and joint issues in patients with pustulosis palmoplantaris. Early consideration aids diagnosis and treatment of this inflammatory condition.
Area of Science:
- Rheumatology
- Dermatology
- Nuclear Medicine
Background:
- Pustulotic arthro-osteitis is a rare inflammatory condition affecting the musculoskeletal system.
- It is often associated with pustulosis palmoplantaris, a chronic skin disorder.
Observation:
- Four cases presented with anterior chest wall symptoms including sternoclavicular and costochondral joint pain and swelling.
- Standard chest X-rays were normal, but technetium-99m scintigraphy showed increased uptake in affected areas.
Findings:
- Laboratory tests were largely normal, with elevated erythrocyte sedimentation rate and C-reactive protein in two cases.
- Patients showed moderate improvement with non-steroidal anti-inflammatory drugs and etretinate or topical PUVA therapy.
Implications:
- Pustulotic arthro-osteitis should be suspected in patients with pustulosis palmoplantaris experiencing anterior chest wall pain.
- This condition requires consideration in the differential diagnosis of inflammatory arthropathies.
- Combined dermatological and rheumatological management may be beneficial.