Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome is an acronym for synovitis, pustulosis, acne, hyperostosis, and osteitis, and clinically manifests as dermatological and musculoskeletal damage. Two major manifestations that cooccur in a single patient are rare. Methods/Results: This literature describes a 44-year-old male affected by SAPHO syndrome, whose first manifestation was palmoplantar pustulosis (PPP). Symptomatic treatments such as anti-inflammatory and analgesics did not work well for him. Adalimumab provided noteworthy improvement in the neck and thoracic back pain improvement after two weeks. The palmoplantar pustules were alleviated after four weeks. Conclusion:The literature on SAPHO syndrome therapy is increasing. Thus, adalimumab is a novel therapeutic agent. This report demonstrates the efficiency of adalimumab in SAPHO syndrome.

Bullous pemphigoid (BP) is an autoimmune blistering disease mainly affecting elderly individuals. Comorbidities are common in patients with BP and have been found to complicate the management and prognosis. We describe a patient with multiple comorbidities who was successfully treated with omalizumab and suggest omalizumab as a good alternative therapy for BP to prevent treatment-related complications in elderly patients with a poor general condition.

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