Palmoplantar pustulosis with pustulotic arthroosteitis involving temporal osteomyelitis and meningitis.
A 46-year-old man who had been suffering from palmoplantar pustulosis (PPP) for 3 years had anterior chest pain and left temporal pain from six months after the onset of his disease. A bone scan revealed abnormal uptake at the sternoclavicular joint and left temporal region. The head CT and MRI gave the diagnosis of temporal osteomyelitis with meningitis and myositis. His headache continued even after tonsillectomy and was effectively treated with cyclosporine A (3 mg/kg/day). Oral cyclosporine A was beneficial for the osteomyelitis and skin lesions. Sterile lytic bone lesions occurring most often at the sternocostoclavicular joint have been associated with PPP. However, there have been no reports of a PPP patient with temporal osteomyelytic involvement.
Seno
A
A
Department of Dermatology, Mitoyo General Hospital, Kagawa, Japan.
Arata
J
J
Matsuura
Y
Y
Suemitsu
I
I
D020083:Acquired Hyperostosis Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D002637:Chest Pain / Q000209:etiology; D016572:Cyclosporine / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011565:Psoriasis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D011626:Pterygoid Muscles / Q000000981:diagnostic imaging / Q000473:pathology; D011877:Radionuclide Imaging; D013247:Sternoclavicular Joint / Q000000981:diagnostic imaging; D013701:Temporal Bone / Q000000981:diagnostic imaging; D013703:Temporal Muscle / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014068:Tonsillectomy
D003879:Dermatologic Agents; D016572:Cyclosporine