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SAPHO Syndrome

Medical Author: William C. Shiel Jr., MD, FACP, FACR

What is SAPHO syndrome?

SAPHO syndrome is a chronic disorder that involves the skin, bone, and joints. SAPHO is an eponym for the combination of synovitis, acne, pustulosis, hyperostosis, and osteitis.

Synovitis means inflammation of the joint lining (synovium). Typically, this is manifests as warmth, tenderness, pain, swelling, and stiffness of involved joints (arthritis).

Acne is a skin condition featuring tiny areas of inflammation with pus formation at the hair follicles. Acne occurs most commonly on the face and upper back.

Pustulosis is a very inflammatory skin condition resulting in large fluid-filled blister-like areas (pustules), typically on the palms of the hands and/or the soles of the feet. The skin of these areas peels and flakes (exfoliates).

Hyperostosis means abnormal excessive growth of bone. The hyperostosis of the SAPHO syndrome frequently is located at the points of the bone where tendons attach.

Osteitis means inflammation of the bone. Patients with SAPHO syndrome can develop inflammation of the sacroiliac joints (sacroiliitis) as well as inflammation of the spine (spondylitis) which leads to stiffness and pain of the neck and back.

Is SAPHO syndrome related to other joint conditions?

Some researchers feel that the SAPHO syndrome is related to the group of arthritis conditions which typically affect the spine, called the spondyloarthropathies. For further information, please read the Ankylosing Spondylitis and Reactive Arthritis articles.

What is treatment for SAPHO syndrome?

Treatment of patients with SAPHO syndrome is directed toward the individual symptoms that are present. Generally, treatment involves medications that reduce inflammation in the particular tissues affected. Examples of medications that are used for inflammation include nonsteroidal antiinflammatory drugs (NSAIDs, such as aspirin, ibuprofen, and naproxen) and cortisone medications (either in the form of topical creams, tablets, or by injection into the involved area). Topical cold applications can also help reduce inflammation in some tissues. For patients with persisting joint symptoms, both sulfasalazine and methotrexate have been tried with varying degrees of success.

SAPHO Syndrome At A Glance
  • SAPHO syndrome is a chronic disorder that involves the skin, bone, and joints.
  • SAPHO is an eponym for the combination of synovitis, acne, pustulosis, hyperostosis, and osteitis.
  • Some researchers feel that the SAPHO syndrome is related to the group of arthritis conditions which typically affect the spine, called the spondyloarthropathies.
  • Treatment of SAPHO syndrome typically involves medications which reduce inflammation.

Last Editorial Review: 11/2/2007




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SAPHO Syndrome

What is reactive arthritis?

Reactive arthritis is a chronic form of arthritis featuring the following three conditions: (1) inflamed joints, (2) inflammation of the eyes (conjunctivitis), and (3) inflammation of the genital, urinary, or gastrointestinal systems.

This form of joint inflammation is called "reactive arthritis" because it is felt to involve an immune system that is "reacting" to the presence of bacterial infections in the genital, urinary, or gastrointestinal systems. Accordingly, certain people's immune systems are genetically primed to react aberrantly when these areas are exposed to certain bacteria. The aberrant reaction of the immune system leads to spontaneous inflammation in the joints and eyes. This can be confounding to the patient and the doctor when the infection has long passed at the time of presentation with arthritis or eye inflammation.

Reactive arthritis has, in the past, been referred to as Reiter syndr...

Read the Reactive Arthritis article »











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