AI Article Synopsis
- - Pustulotic arthro-osteitis (PAO) is a common condition linked to palmoplantar pustulosis (PPP), particularly among Japanese patients, with a study identifying PAO in 28.6% of those with PPP.
- - The study involved 165 PAO patients, predominantly middle-aged women, with a mean age of 50.2 years and a significant number being smokers; focal infections were common, affecting various regions, especially the tonsils.
- - Treatment for PAO typically includes nonsteroidal anti-inflammatory drugs, methotrexate, and other therapies, reflecting its complexity and the associations with infections in the chest area.
Article Abstract
Background: Pustulotic arthro-osteitis (PAO) is a major comorbidity of palmoplantar pustulosis (PPP), which is frequently seen in Japanese patients. To determine the characteristics of Japanese patients with PAO, we conducted a multicenter, retrospective epidemiologic survey at four university hospitals.
Methods: Clinical features including age, gender, duration of disease, extrapalmoplantar lesion, smoking habit, focal infection, site of joint pain, bone scintigraphy with Technetium , and therapies were retrospectively evaluated.
Results: In total, 165 patients with PAO were identified among 576 patients with PPP (28.6%). The male to female ratio was 1 : 3.7, and the mean age was 50.2 years. The mean disease duration of PAO was 6.0 years. Smoking habit was observed in 104 patients. Focal infection was detected in 74 patients, who developed tonsillar infection (n = 41), sinusitis (8), odontogenic infection (40), and others (2). Fifteen patients had multifocal infection. Technetium bone scintigraphy was performed in 97 cases. Increased uptake was most frequently observed in the sternocostoclavicular regions, followed by wrist and ankle, sacroiliac joint, knee and elbow, finger and toe, lumbar spine, thoracic spine, scapula, and thigh. Patients were mainly treated with nonsteroidal anti-inflammatory drugs, methotrexate, cyclosporine, antibiotics, and biologics, as well as tonsillectomy and dental treatment.
Conclusion: PAO frequently involves the anterior chest wall of middle-aged women with smoking habit and is closely associated with focal infection.
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| http://dx.doi.org/10.1111/ijd.14788 | DOI Listing |
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