DOI: 10.36347/sjmcr.2021.v09i01.009

Pages: 34-38

SAPHO syndrome is an acronym for “Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis”. It is combination of cutaneous and musculoskeletal manifestations, such as osteoarthritis and hyperostosis of bones of the anterior chest wall associated with acne fulminans and hidradenitis suppurativa. We present the case of a 15-year old boy with osteoarthritis of the left hip, osteitis of the left carpal bones and right clavicula with acne conglobata. Bone biopsy of the left hip has been carried out and Propionibacterium acnes was found in the bone lesion. Identification of the Propionibacterium acnes from bone biopsy in SAPHO syndrome has occasionally been reported, which could suggest that microorganisms could be a trigger for osteitis and hyperostosis and may play the role in the pathogenesis of the disease. Our patient was treated with nonsteroidal anti-inflammatory drugs, antibiotics and a corticosteroids, which resulted in clinical improvement, but not complete remission, so we introduced methotrexate in therapy. The purpose of this case study is to raise awareness to a set of clinical features of SAPHO syndrome and its early recognition and prompt therapy.