Synovitis-acne-pustulosis-hyperostosis-osteitis syndrome: A dermatologist's diagnostic dilemma

Abstract

To the Editor: Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome emphasizes the connection between skin and bone diseases.1 Palmoplantar pustulosis and severe acne conglobata or fulminans are well-known features, but pustular psoriasis, dissecting cellulitis of the scalp, hidradenitis suppurativa, Sweet's syndrome, and Sneddon-Wilkinson disease have all been reported in association with the syndrome. When skin disease is mild or absent, this diagnosis is difficult to make.