Vertebral lesions associated with palmoplantar pustulosis.
Spinal lesions were reviewed in 9 patients (3 men and 6 women) who presented with palmoplantar pustulosis. Cervical lesions were found in 3 patients and lumbosacral involvement in 7. The duration of disease averaged 4.8 years. Seven patients had associated sterno-costo-clavicular hyperostotic lesions, and all showed abnormalities in blood tests which suggested chronic inflammation. Vertebral lesions were assessed as a spondylodiscitis type in 4, single level syndesmophyte-forming type in 1, multiple hyperostosis type in 4, and an ivory vertebra type in 1. Five patients were treated conservatively, and 4 with progressive spondylodiscitis type lesions underwent curettage and anterior interbody fusions. At follow-up, all patients improved in both spinal and cutaneous presentations, and 4 who underwent surgery and 1 with tonsillectomy attained complete cure. The vertebral manifestations of palmoplantar pustulosis may vary, but rapidly progressive lesions need surgery for favourable early improvement from the vertebro-cutaneous symptom complex.
Baba
H
H
Department of Orthopaedic Surgery, Fukui Medical School, Japan.
Uchida
K
K
Wada
M
M
Imura
S
S
Kawahara
N
N
Tomita
K
K
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology*