Pustulotic Arthro-Osteitis (Sonozaki Syndrome): A Case Report and Review of Literature

Köse, Reyhan; Şentürk, Taşkın; Sargın, Gökhan; Çildağ, Songül; Kara, Yasemin

doi:10.5152/eurasianjmed.2018.17268

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…Some PPP patients are associated with arthro‐osteitis, called pustulotic arthro‐osteitis (PAO) 3,4 . PAO mainly affects sterno‐costo‐clavicular joints, inducing their painful swelling, but also axial, sacroiliac, or peripheral joints 5 . The expression of tumor necrosis factor (TNF)‐α and inerleukin (IL)‐17‐related cytokines, like IL‐17A, IL‐17C, IL‐17F, IL‐22, and IL‐23, is elevated in PPP lesions, and TNF‐α/IL‐23/IL‐17 inflammatory axis may play important roles in the pathogenesis of PPP 6 .…”

Section: Introductionmentioning

confidence: 99%

Dietary habits in Japanese patients with palmoplantar pustulosis

Serizawa

Okazaki

Otsuka

et al. 2021

The Journal of Dermatology

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Palmoplantar pustulosis (PPP) is a chronic dermatitis characterized by sterile intra‐epidermal pustules associated with erythema and scales on the palms and soles. Tumor necrosis factor (TNF)‐α/interleukin (IL)‐23/IL‐17 inflammatory pathway may be involved in the pathogenesis of PPP, and the skin lesions manifest the enhanced expression of IL‐8 in keratinocytes and increased levels of antimicrobial peptide cathelicidin, leucine leucine‐37 in vesicles/pustules. Some PPP patients are associated with arthro‐osteitis, called pustulotic arthro‐osteitis (PAO). Dietary habits may modulate the pathogenesis of PPP, however, have not been investigated in PPP patients. We evaluated dietary habits in adult Japanese PPP patients, using a validated, brief‐type self‐administered diet history questionnaire, and compared their results to those of age‐ and sex‐matched healthy controls. The results in PPP patients with PAO were compared to those in the patients without. Japanese PPP patients showed higher body mass indices (BMIs), higher intakes of pulses and sugar/sweeteners, and lower intake of vitamin A, compared to those of healthy controls. The bivariate and multivariable logistic regression analysis showed that PPP was associated with high BMI, high intake of pulses, and low intake of vitamin A. The sodium intake and BMI were positively correlated with palmoplantar pustulosis area and severity index (PPPASI). The linear multivariate regression analysis revealed that sodium intake and BMI were predictors of PPPASI. The age and sodium intake in the patients with PAO were lower than those in the patients without. The bivariate and multivariable logistic regression analysis showed that PAO was negatively associated with age and sodium intake. This is the first study showing the dietary habits in patients with PPP. Further studies should clarify if the dietary intervention to correct the BMI and sodium intake will alter the progress of PPP.

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Section: Introductionmentioning

confidence: 99%

Dietary habits in Japanese patients with palmoplantar pustulosis

Serizawa

Okazaki

Otsuka

et al. 2021

The Journal of Dermatology

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“…In a few case reports, elevated CRP levels were noted among patients with PAO 4,36,37 and lowering in CRP level was associated with alleviating symptoms of PAO. Findings from our study show no clear correlation between improvements in MRI scores and CRP levels.…”

Section: Discussionmentioning

confidence: 98%

“…To date, the literature for PAO is sparse, limited mostly to case reports or small case series, and there is a lack of well‐documented clinical studies 4,10,12,36,37 . In a study including 10 patients with PAO treated weekly with granulocyte and monocyte adsorption apheresis over 5 weeks, improvement in joint symptoms in 5/10 patients was demonstrated 38 .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of guselkumab in a subpopulation with pustulotic arthro‐osteitis through week 52: an exploratory analysis of a phase 3, randomized, double‐blind, placebo‐controlled study in Japanese patients with palmoplantar pustulosis

Yamamoto

Fukuda

Morita

et al. 2020

Acad Dermatol Venereol

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Background Previous studies of guselkumab have demonstrated clinical benefits in patients with plaque-type psoriasis, generalized pustular psoriasis, erythrodermic psoriasis and palmoplantar pustulosis (PPP). Objective The aim of this exploratory analysis of a double-blind, multicenter, placebo-controlled, phase 3 study in Japanese patients with PPP was to evaluate the efficacy of guselkumab in the subset of patients with pustulotic arthroosteitis (PAO). Methods Patients were randomized to receive guselkumab 100 or 200 mg at weeks 0, 4, 12 and every 8 weeks, or placebo with cross-over to guselkumab 100 or 200 mg at week 16 (placebo group). Efficacy endpoints were changes from baseline in magnetic resonance imaging (MRI) score, EuroQOL-5 dimensions (EQ-5D) index score, EQ-5D pain/discomfort dimension score and C-reactive protein (CRP, mg/L) level in all PAO patients through week 52. Data from both guselkumab groups were combined and presented as results for a single overall guselkumab group. Results Among 159 patients with PPP, 66 with PAO were randomized across treatment groups. For patients with MRI data for all regions assessed, the proportion of patients in the guselkumab group with PAO characterized as severe decreased from 23.8% (10/42) at baseline to 5.4% (2/42) at week 52. The mean (SD) change from baseline at week 52 in EQ-5D index score was 0.20 (0.17) among PPP patients with PAO and 0.15 (0.17) among those without PAO in the guselkumab group. Among all PAO patients, the proportions with an EQ-5D pain/discomfort dimension score of no or slight pain/ discomfort in the guselkumab group increased from baseline to week 52 [33.3% (7/21) vs. 87.5% (35/40)]. The mean (SD) CRP levels decreased in all PAO patients in the guselkumab group at week 52 compared to baseline [À1.71 (8.16) mg/L]. Conclusion Guselkumab treatment showed beneficial outcomes for PAO signs and symptoms in Japanese patients with PPP.

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“…The involvement of a rheumatologist may also be required if the patient has psoriatic arthritis, pustulotic arthro-osteitis (PAO; Sonozaki syndrome), or synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome. (PAO and SAPHO are reviewed in these reports [42,43]. )…”

Section: When Should a Patient Be Referred To A Dermatologist?mentioning

confidence: 99%

A brief guide to pustular psoriasis for primary care providers

Crowley¹,

Pariser

Yamauchi

2020

Postgraduate Medicine

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Pustular psoriasis refers to a heterogeneous group of chronic inflammatory skin disorders that are clinically, histologically, and genetically distinct from plaque psoriasis. Pustular psoriasis may present as a recurrent systemic illness (generalized pustular psoriasis [GPP]), or as localized disease affecting the palms and/or soles (palmoplantar pustulosis [PPP], also known as palmoplantar pustular psoriasis), or the digits/nail beds (acrodermatitis continua of Hallopeau [ACH]). These conditions are rare, but their possible severity and consequences should not be underestimated. GPP, especially an acute episode (flare), may be a medical emergency, with potentially life-threatening complications. PPP and ACH are often debilitating conditions. PPP is associated with impaired health-related quality of life and psychiatric morbidity, while ACH threatens irreversible nail and/or bone damage. These conditions can be difficult to diagnose; thus, primary care providers should not hesitate to contact a dermatologist for advice and/or patient referral. The role of corticosteroids in triggering and leading to flares of GPP should also be noted, and physicians should avoid the use of systemic corticosteroids in the management of any form of psoriasis.

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Pustulotic Arthro-Osteitis (Sonozaki Syndrome): A Case Report and Review of Literature

Cited by 8 publications

References 12 publications

Dietary habits in Japanese patients with palmoplantar pustulosis

Dietary habits in Japanese patients with palmoplantar pustulosis

Efficacy of guselkumab in a subpopulation with pustulotic arthro‐osteitis through week 52: an exploratory analysis of a phase 3, randomized, double‐blind, placebo‐controlled study in Japanese patients with palmoplantar pustulosis

A brief guide to pustular psoriasis for primary care providers

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