[Anterior thoracic and intervertebral erosive joint diseases associated with palmoplantar pustulosis].
The authors report three cases of palmo-plantar pustulosis associated with articular signs: erosive arthritis of the right first sternocostal joint in 2 cases (without hypertrophy of the clavicle or the sternum) and atlanto-occipital arthropathy with marked neck stiffness in another case. The HLA phenotype of one case was: A2 - A9 - B14 - X - DR3 - DR4. A surgical sterno-costal biopsy revealed non-specific inflammatory lesions in 2 cases. In one of these cases, a Corynebacterium sp. was isolated. The clinical course was favourable in response to local antibiotic therapy in one case (follow-up of 8 years) and after treatment with non-steroidal anti-inflammatory agents in 2 cases (follow-up of one to two years). The skin biopsy revealed non-spongiform (and therefore non-psoriatic) unilocular pustulosis, distinguishing this non-bacterial pustulosis from pustular palmo-plantar psoriasis with which it is frequently confused. These cases are similar to the cases of "pustulotic arthro-osteitis" reported by Japanese authors (Sonozaki et al.), which appear to be rare in Europe. They seem to be an early form in a vast range of spondylo-arthropathies including rheumatism and acne conglobata. The aetio-pathogenesis of this syndrome is discussed; one of the cases is strongly suggestive of an infectious origin (Corynebacterium). These lesions do not appear to be a form of reactive arthritis, as the presence of HLA B27 is rare in both the European and the Japanese cases.
D000328:Adult; D001168:Arthritis / Q000150:complications* / Q000000981:diagnostic imaging; D001170:Arthritis, Infectious / Q000150:complications; D001269:Atlanto-Occipital Joint / Q000000981:diagnostic imaging; D003354:Corynebacterium Infections / Q000150:complications; D005260:Female; D005533:Foot Dermatoses / Q000150:complications* / Q000473:pathology; D006229:Hand Dermatoses / Q000150:complications* / Q000473:pathology; D006801:Humans; D007596:Joints / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012867:Skin / Q000473:pathology; D013248:Sternocostal Joints / Q000000981:diagnostic imaging / Q000473:pathology; D013492:Suppuration / Q000150:complications
Arthropathies érosives thoraciques antérieures et intervertébrales associées à la pustulose palmoplantaire.