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SAPHO syndromeSynovitis Acne Palmoplantar Pustulosis Hyperostosis Osteitis. A rare association of severe acne and arthralgia/arthritis, which is more common in men.
The acne affects the face, upper back and trunk, and is accompanied by fever and weight loss. The pain usually affects the hips, knees, shoulders, and occasionally other sites. The arthritis usually affects the lower limbs; it may be acute and polyarticular.
Increased erythrocyte sedimentation rate (ESR), increased leukocytes, decreased serum complement, negative ANA, negative rheumatoid factors, presence of circulating immune complexes.
NSAIDs for pain, arthritis; corticosteroids for severe pain and recalcitrant acne.