title: Vertebral lesions associated with palmoplantar pustulosis.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Fukui Medical School, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Baba
authors.forename: K
authors.initials: K
authors.lastname: Uchida
authors.forename: M
authors.initials: M
authors.lastname: Wada
authors.forename: S
authors.initials: S
authors.lastname: Imura
authors.forename: N
authors.initials: N
authors.lastname: Kawahara
authors.forename: K
authors.initials: K
authors.lastname: Tomita
mesh_terms: 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*