Vol 39 # 2 June 2007 - Kma.org.kw

June 2007KUWAIT MEDICAL JOURNAL 175Fig. 1: Swelling over the left sternoclavicular jointFig. 2: Scaly papules with occasional pustules on the trunkFig. 3: CT chest showing areas of reported residual scarringDISCUSSIONSAPHO was first described in 1987 [1] and ischaracterized by variable bony involvement withor without a concurrent pustular dermatosis.Affected bones include the chest wall, sacroiliacjoints and long bones. Bony changes includehyperostosis, aseptic osteomyelitis, and arthritis.Skin involvement is also variable and includes oneor more of the following: palmoplantar pustulosis,acne conglobata or fulminans, hidradenitissuppurativa, pustular psoriasis and dissectingcellulitis of the scalp.Benhamou and others described four majordiagnostic criteria to establish the diagnosis [2] . Anyone of the following is regarded as sufficient todiagnose SAPHO:• Acne conglobata, acne fulminans, orhidradenitis suppurativa with osteoarticularmanifestationsFig. 4: Bilateral linear densities at lung bases.