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Pustulotic arthroosteitis (PAO) is a rare chronic inflammatory arthropathy associated with palmoplantar pustulosis (PPP). PAO involves various extra-palmoplantar sites, including spinal lesions. Systemic treatment, including biologics, is required for refractory cases of PAO. We herein report a man diagnosed with PAO who predominantly manifested spinal symptoms. Initial treatment with non-steroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and bisphosphonates achieved a minimal response. Risankizumab, an anti-IL-23 p19 antibody, was subsequently administered, which resulted in significant improvement after the fourth dose, resolving both spinal and cutaneous manifestations. This case report highlights risankizumab as a potential therapeutic option for refractory PAO with spinal involvement.
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http://dx.doi.org/10.2169/internalmedicine.5979-25 | DOI Listing |
Am J Clin Dermatol
September 2025
Department of Dermatology, National Taiwan University Hospital, Taipei City, Taiwan.
Background: Ethnic differences in the clinical and molecular features of many immune-mediated dermatoses have been reported, including psoriasis vulgaris and generalized pustular psoriasis. Palmoplantar pustulosis (PPP) is a chronic and relapsing inflammatory skin disease manifesting as crops of sterile pustules over an erythematous base on the palms and soles. To date, ethnic differences in PPP have been rarely studied.
View Article and Find Full Text PDFIntern Med
August 2025
Department of Radiology, St Francisco Hospital, Japan.
Pustulotic arthroosteitis (PAO) is a rare chronic inflammatory arthropathy associated with palmoplantar pustulosis (PPP). PAO involves various extra-palmoplantar sites, including spinal lesions. Systemic treatment, including biologics, is required for refractory cases of PAO.
View Article and Find Full Text PDFJ Clin Rheumatol
September 2025
Division of Rheumatology, Teikyo University Medical Center in Chiba, Chiba, Japan.
Mod Rheumatol Case Rep
July 2025
Department of Orthopaedic Surgery, Toho University Sakura Medical Center, Chiba, Japan.
SAPHO syndrome is a rare inflammatory osteoarticular disorder, which includes autoimmune diseases such as pustulotic arthro-osteitis, inflammatory bowel disease-associated spondyloarthritis, and psoriatic arthritis. There are few reports on the treatment of SAPHO syndrome that presents with bone destruction in the spine. We present a case in which adalimumab (ADA) was administered to treat destruction of the lumbar vertebral endplates caused by SAPHO syndrome.
View Article and Find Full Text PDFJ Dermatol
April 2025
Department of Dermatology, Tokyo Medical University, Tokyo, Japan.
Granulocyte and monocyte adsorptive apheresis (GMA) selectively removes activated granulocytes and monocytes from the peripheral blood. In 2012, GMA was approved in Japan as a treatment for generalized pustular psoriasis and localized pustular psoriasis or palmoplantar pustulosis (PPP). Limited evidence from case reports and monocentric studies suggested that GMA is an effective treatment for skin and joint symptoms of PPP with pustulotic arthro-osteitis (PAO).
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