SAPHO syndrome includes a variety of inflammatory bone disorders that may be associated with skin changes. These diseases share some clinical, radiologic, and pathologic characteristics.
An entity initially known as chronic recurrent multifocal osteomyelitis was first described in 1972.[1] Subsequently, in 1978,[2] several cases of were associated with blisters on the palms and soles (palmoplantar pustulosis). Since then, a number of associations between skin conditions and osteoarticular disorders have been reported under a variety of names, including sternocostoclavicular hyperostosis, pustulotic arthro-osteitis, and acne-associated spondyloarthropathy. The term SAPHO (an acronym for synovitis, acne, pustulosis, hyperostosis, osteitis) was coined in 1987[3] to represent this spectrum of inflammatory bone disorders that may or may not be associated with dermatologic pathology.
Anterior chest wall (most common site, 65–90% of patients):[citation needed] Hyperostosis, sclerosis and bone hypertrophy especially involving the sternoclavicular joint, often with a soft tissue component.
Spine (33% of patients):[citation needed] Segmental, usually involving the thoracic spine. The four main presentations include spondylodiscitis, osteosclerosis, paravertebral ossifications, and sacroiliac joint involvement.
Long bones (30% of patients):[citation needed] usually metadiaphyseal and located in the distal femur and proximal tibia. It looks like chronic osteomyelitis but will not have a sequestrum or abscess.
Flat bones (10% of patients):[citation needed] mandible and ilium.
Peripheral arthritis has been reported in 92% of cases of SAPHO as well.[citation needed]
In children, the SAPHO syndrome is most likely to affect the metaphysis of long bones in the legs (tibia, femur, fibula), followed by clavicles and spine.
Some patients have responded to antibiotics. The rationale for their use is that Cutibacterium acnes, a bacterium known for its role in acne, has been isolated from bone biopsies of SAPHO patients.[7][9]
^Giedion A, Holthusen W, Masel LF, Vischer D (1972). "Subacute and chronic "symmetrical" osteomyelitis". Annals of Radiology. 15 (15): 329–42. PMID4403064.
^Bjorksten B, Gustavson KH, Eriksson B, et al. (1978). "Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris". Journal of Pediatrics. 93 (2): 227–31. doi:10.1016/S0022-3476(78)80501-0. PMID671154.
^Chamot AM, Benhamou CL, Kahn MF, Beraneck L, Kaplan G, Prost A (1987). "Acne-pustulosis-hyperostosis-osteitis syndrome. Results of a national survey. 85 cases". Revue du Rhumatisme et des Maladies Osteo-Articulaires. 54 (3): 187–96. PMID2954204.
^Ichikawa J, Sato E, Haro H, Ando T, Maekawa S, Hamada Y (November 2008). "Successful treatment of SAPHO syndrome with an oral bisphosphonate". Rheumatology International. 29 (6): 713–5. doi:10.1007/s00296-008-0760-z. PMID18998139. S2CID151512.
^Scarpato S, Tirri E (2005). "Successful treatment of SAPHO syndrome with leflunomide. Report of two cases". Clinical and Experimental Rheumatology. 23 (5): 731. PMID16173265.
