Síndrome SAPHO - primeros casos en el Ecuador
DOI:
https://doi.org/10.29176/2590843X.695Palabras clave:
SAPHO, acné, hiperostosis, pustulosisResumen
El Síndrome SAPHO debe su nombre a un acrónimo constituido de la siguiente forma: S: sinovitis, A: acné conglobata; P: pustulosis palmo- plantar; H: hiperostosis; O: osteítis.
Se lo define como una enfermedad reumática recurrente, cuyas principales características son la afección hiperosteosante del tórax, pustulosis palmo-plantar y/o acné grave. Afecta a adolescentes y adultos jóvenes de ambos sexos, siendo más frecuente en los países nórdicos de Europa y el Japón. Su etiología es desconocida, pero se cree que se debe a una reacción articular producto de fenómenos inmunológicos provocados por Propinebacterium acnes. Su diagnóstico se basa en los hallazgos clínicos y radiológicos. El tratamiento es sintomático; sin embargo, se han reportado excelentes resultados en cuanto se refiere a la sintomatología articular y cutánea con el uso de isotretinoína oral.
Presentamos dos pacientes varones, un adolescente y otro adulto joven, que comparten características clínicas típicas de esta patología.
Biografía del autor/a
Eduardo Garzón Aldás, Universidad Central del Ecuador
Medico Tratante, Profesor Postgrado en Dermatología Universidad Central del Ecuador, Hospital Dermatológico Gonzalo González, Quito, Ecuador.
Holguer Garzón Vásconez, Universidad Central del Ecuador
Médico Tratante, Profesor Pre-grado y Postgrado en Dermatología Universidad Central del Ecuador, Hospital Dermatológico Gonzalo González, Quito, Ecuador.
Laura Soria Arteaga, Hospital Dermatológico Gonzalo González
Médica Tratante, Dermatopatóloga, Profesora Postgrado en Dermatología Universidad Estatal de Guayaquil, Hospital Dermatológico Gonzalo González, Quito, Ecuador.
Referencias bibliográficas
1. Benhamou C, ChamotAM, Kahn MF. Synovitis, acne, pustulosis, hyperostosis, osteítis (SAPHO) syndrome. Ann Dermatol Venereol 1988; 115:613-618.
2. Chamot AM, et al. Acne-pustulosis-hyperostosis osteitis syndrome. Results of a national survey. 85 cases. Rev Rheum Mal Osteoartic 1987; 54:187-196.
3. Benhamou CL, Chamot AM, Kahn MF. Synovitis acne-pustulosis hyperostosis-osteomyelitis syn drome (SAPHO). A new syndrome among the spondyloarthropathies? Clin Exp Rheumatol 1988; 6:109-112.
4. Maugars Y, et al. SAPHO syndrome: a follow-up study of 19 cases with special emphasis on enthesis involvement. J Rheumatol 1995; 22:2135-2141.
5. Prigent D, Gras C. SAPHO: first Polynesian case. Rev Rheum Mal Osteoartic 1992; 59:234-235.
https://doi.org/10.2307/2554748
6. GoupilleP,ValatJP. SAPHOsyndromeandspondy loarthropathy. J Rheumatol 1996; 23: 1667-1668.
7. Cotten A, Delaporte E, F lipo RM. Sapho syndrome. Rev Med Interne 1996; 17:341-345.
https://doi.org/10.1016/0248-8663(96)81440-8
8. Schilling F, Schweden F. Lumbo-sacroiliac hyperos tosis with retroperitoneal fibrosis in spondarthritis hyperostotical pustulo-psoriatica -with sternocos toclavicular hyperostosis and superior and inferior venous obstruction syndrome: pathogenetic hypo thesis of fibro-osteopathia psoriatica. Rheumatol 1996; 55:331-347.
9. Dihlmann W, Kaiser H. Current aspects of SAPHO syndrome. Rheumatol 1996; 55:73-74.
10. Dihlmann W, Hering L. Why the "SAPHO" syndrome? J Rheumatol 1996; 23:1308-1310.
11. Kotilainen P, et al. Propionibacterium acnes isolated from sternal osteítis in a patient with SAPHO syndrome. J Rheumatol 1996; 23:1302-1304.
12. Olive A, Tena X. SAPHO: a syndrome in the process of development. Med Clin Barc 1994; 102:492-493.
13. Trotta F, La Corte R, Bajocchi G. Hyperostosis and multifocal osteítis: a purely rheumatological subset of the SAPHO syndrome. Clin Exp Rheumatol 1990; 8:401-405.
14. Scarpa R et al. Subcorneal pustular dermatosis (Sneddon-Wilkinson syndrome): another cutaneous manifestation of SAPHO syndrome? Br J Rheumatol 1997; 36:602-603.
https://doi.org/10.1093/rheumatology/36.5.602
15. Cuellar ML, Silveira LH, Espinoza LR. Recent developments in psoriatic arthritis. Curr Opin Rheumatol 1994; 6:378-384.
https://doi.org/10.1097/00002281-199407000-00005
16. Veale D, Rogers S, Fitzgerald O. Classification of clinical subsets in psoriaticarthritis. BrJRheumatol 1994; 33:133-138.
https://doi.org/10.1093/rheumatology/33.2.133
17. Suei T et al. Case report. Synovitis, acne, pustulosis, hyperostosis and osteítis. Radiology 1996; 25:287-291.
https://doi.org/10.1259/dmfr.25.5.9161184
18. Nagel T, Eger G, Kalden JR, Manger B. Arthroosteitis pustulosa, spondarthritis hyperostotica pustulopsoriatica, SAPHO syndrome: clinical experiences and review of the literature. Rheumatol1993; 52:390- 397.
19. Chamot AM. Psoriatic rheumatism and a related new entity, SAPHO, synovitis, acne, pustulosis, hyperostosis, osteítis syndrome. Rev Med Suisse Romande 1990; 110:859-863.
20. Claudepierre P et al. SAPHO syndrome and pyoderma gangrenosum: is it fortuitous?. J Rheumatol 1996; 23:400-402.
21. Sanjuan Portugal F et al. The SAPHO syndrome and ulcerative colitis. An Med Interna. 1997; 14:210-211.
22. Gutzmer R, Herbst RA, Kapp A, Weiss J. SAPHO syndrome. Case description of 3 patients with acne conglobata and osteoarticular symptoms. Hautarzt 1997; 48:186-190.
https://doi.org/10.1007/s001050050568
23. Bolukbas N, Bolukbas S, Erel A, Tali ET. Sapho syndrome associated with acne fulminans and prominent acromioclavicular joint involvement. Scand J Rheu matol 1996; 25:180-182.
https://doi.org/10.3109/03009749609080012
24. Jana H, Pavel K. The SAPHO syndrome in a 16 year old boy: coincidence of acne conglobata and osteoarthritis. J Adolesc Health 1993; 14:120-123.
https://doi.org/10.1016/1054-139X(93)90096-8
25. Andrews GC, Machacek GF. Pustular bacterides of the hands and feet. Arch Dermatol Syph 1935; 32: 327-347.
https://doi.org/10.1001/archderm.1935.01470060002001
26. Pons JC, Nekhlyudov L, Delfraissy JF. The course of the SAPHO syndrome during pregnancy. Eur J Obstet Gynecol Reprod Biol 1996; 70:215-216.
https://doi.org/10.1016/S0301-2115(95)02588-X
27. Toussirot E, Dupond JL, Wendling D. Spondylodiscitis in SAPHO syndrome. A series of eight cases. Ann Rheum Dis 1997; 56:52-58.
https://doi.org/10.1136/ard.56.1.52
28. Reith JD, Bauer TW, Schils JP. Osseous mani festations of SAPHO (synovitis, acne, pustulosis, hyperostosis, osteítis) syndrome. Am J Surg Pathol 1996; 20:1368-1377.
https://doi.org/10.1097/00000478-199611000-00008
29. Watts RA et al. Arthro-osteitis - a clinical spectrum. BrJRheumatol1993; 32:403-407.
https://doi.org/10.1093/rheumatology/32.5.403
30. Cotten A et al. SAPHO syndrome. Radiographics 1995; 15:1147-1154.
https://doi.org/10.1148/radiographics.15.5.7501856
31. Dihlmann W, Dihlmann SW, Hering L. Acquired hype rostosis syndrome -AHYS-(sternocostoclavicular hyperostosis, pustulotic arthro-osteitis, SAPHO syndrome): bone scintigraphy of the anterior chest wall. Clin Rheumatol 1997; 16:13-24.
https://doi.org/10.1007/BF02238758
32. Olivieri I et al. Ankylosing spondylitis with exuberant sclerosis or SAPHO syndrome? J Rheumatol 1993; 20:202-203.
33. Vignot E, Colson F, Tebib JG, Bouvier M. Vertebral osteosclerosis, sacro-iliitis and palmoplantar derma� titis. Apropos of a case. Ann Radio! París 1992; 35:225-228.
34. Vecchio PC, Marlton PV, Webb J. Noninfectious osteítis: part of the SAPHO syndrome. Clin Rheu matol 1992; 11:371-375.
https://doi.org/10.1007/BF02207195
35. Kahn MF et al. Sternoclavicular pustulotic osteítis (SAPHO). 20 year interval between skin and bone lesions. J Rheumatol 1991; 18:1104-1108.
36. Beraneck L, Kaplan G, Girardet JP. Multifocal recurrent chronic osteítis. Course over 12 years. Correlation with SAPHO syndrome. Rev Rhum Mal Osteoartic 1990; 57:473-475.
37. Konczaty H, Bourrillon A, Hayem F. Rheumatism and acne conglobata. a proposal of a new case in a 13 year old boy. Ann Pediatr Paris 1990; 37:231-234.
38. Schreiber S, Starc JM, Thys P. Rapidly destructive spondylitis, a manifestation of SAPHO syndrome. Rev Rhum Mal Osteoartic 1990; 57:217-219.
39. Collange C, Brantus JF, Sidot C, Meunier PJ. Sapho syndrome with femoral hyperostosis. Two case reports. Rev Rheum Engl Ed 1996; 63:367-370.
40. Kahn MF. SAPHO syndrome. Dermatology 1995; 190:85.
https://doi.org/10.1159/000246643
41. Vohradnikova O et al. The SAPHO syndrome. Acta Derm Venereol 1993; 73:208-209.
42. Kahn MF, Khan MA. The SAPHO syndrome. Baillieres Clin Rheumatol 1994; 8:333-362.
https://doi.org/10.1016/S0950-3579(94)80022-7
43. Brandsen RE et al. SAPHO syndrome. Dermatology 1993; 186:176-180.
https://doi.org/10.1159/000247340
44. Grosshans EM. SAPHO: the impossible acronym. Dermatology 1993; 186:161-162.
https://doi.org/10.1159/000247336
45. Kahn MF, Chamo! AM. SAPHO syndrome. Rheum Dis Clin North Am 1992; 18:225- 246.
46. Crepy Al, Veyssier P, Kaloustian E, et al. SAPHO syndrome. A case report. Ann Med Interne Paris 1990; 141:390-391.
47. Garcia-Marin F, lriarte-Ortabe JI, Reychler H. Chronic diffuse sclerosing osteomyelitis of the mandible or mandibular location of S.A.P.H.O. syndrome. Acta Stomatol Belg 1996; 93:65-71.
48. Kahn MF et al. Chronic enterocolopathies and SAPHO syndrome. 8 cases. Rev Rheum Mal Osteoartic 1992; 59:91-94.
49. Gouldden, B et al. Long-term safety of isotretinoin as a treatment for acne vulgaris. Br J Dermatol 1994; 131:360-363.
https://doi.org/10.1111/j.1365-2133.1994.tb08524.x
50. Margolis DJ et al. Effects of isotretinoin on bone mine- ralization during routine therapy with isotretinoin for acne. Arch Dermatol 1996; 132:769-774.
https://doi.org/10.1001/archderm.1996.03890310053007
2. Chamot AM, et al. Acne-pustulosis-hyperostosis osteitis syndrome. Results of a national survey. 85 cases. Rev Rheum Mal Osteoartic 1987; 54:187-196.
3. Benhamou CL, Chamot AM, Kahn MF. Synovitis acne-pustulosis hyperostosis-osteomyelitis syn drome (SAPHO). A new syndrome among the spondyloarthropathies? Clin Exp Rheumatol 1988; 6:109-112.
4. Maugars Y, et al. SAPHO syndrome: a follow-up study of 19 cases with special emphasis on enthesis involvement. J Rheumatol 1995; 22:2135-2141.
5. Prigent D, Gras C. SAPHO: first Polynesian case. Rev Rheum Mal Osteoartic 1992; 59:234-235.
https://doi.org/10.2307/2554748
6. GoupilleP,ValatJP. SAPHOsyndromeandspondy loarthropathy. J Rheumatol 1996; 23: 1667-1668.
7. Cotten A, Delaporte E, F lipo RM. Sapho syndrome. Rev Med Interne 1996; 17:341-345.
https://doi.org/10.1016/0248-8663(96)81440-8
8. Schilling F, Schweden F. Lumbo-sacroiliac hyperos tosis with retroperitoneal fibrosis in spondarthritis hyperostotical pustulo-psoriatica -with sternocos toclavicular hyperostosis and superior and inferior venous obstruction syndrome: pathogenetic hypo thesis of fibro-osteopathia psoriatica. Rheumatol 1996; 55:331-347.
9. Dihlmann W, Kaiser H. Current aspects of SAPHO syndrome. Rheumatol 1996; 55:73-74.
10. Dihlmann W, Hering L. Why the "SAPHO" syndrome? J Rheumatol 1996; 23:1308-1310.
11. Kotilainen P, et al. Propionibacterium acnes isolated from sternal osteítis in a patient with SAPHO syndrome. J Rheumatol 1996; 23:1302-1304.
12. Olive A, Tena X. SAPHO: a syndrome in the process of development. Med Clin Barc 1994; 102:492-493.
13. Trotta F, La Corte R, Bajocchi G. Hyperostosis and multifocal osteítis: a purely rheumatological subset of the SAPHO syndrome. Clin Exp Rheumatol 1990; 8:401-405.
14. Scarpa R et al. Subcorneal pustular dermatosis (Sneddon-Wilkinson syndrome): another cutaneous manifestation of SAPHO syndrome? Br J Rheumatol 1997; 36:602-603.
https://doi.org/10.1093/rheumatology/36.5.602
15. Cuellar ML, Silveira LH, Espinoza LR. Recent developments in psoriatic arthritis. Curr Opin Rheumatol 1994; 6:378-384.
https://doi.org/10.1097/00002281-199407000-00005
16. Veale D, Rogers S, Fitzgerald O. Classification of clinical subsets in psoriaticarthritis. BrJRheumatol 1994; 33:133-138.
https://doi.org/10.1093/rheumatology/33.2.133
17. Suei T et al. Case report. Synovitis, acne, pustulosis, hyperostosis and osteítis. Radiology 1996; 25:287-291.
https://doi.org/10.1259/dmfr.25.5.9161184
18. Nagel T, Eger G, Kalden JR, Manger B. Arthroosteitis pustulosa, spondarthritis hyperostotica pustulopsoriatica, SAPHO syndrome: clinical experiences and review of the literature. Rheumatol1993; 52:390- 397.
19. Chamot AM. Psoriatic rheumatism and a related new entity, SAPHO, synovitis, acne, pustulosis, hyperostosis, osteítis syndrome. Rev Med Suisse Romande 1990; 110:859-863.
20. Claudepierre P et al. SAPHO syndrome and pyoderma gangrenosum: is it fortuitous?. J Rheumatol 1996; 23:400-402.
21. Sanjuan Portugal F et al. The SAPHO syndrome and ulcerative colitis. An Med Interna. 1997; 14:210-211.
22. Gutzmer R, Herbst RA, Kapp A, Weiss J. SAPHO syndrome. Case description of 3 patients with acne conglobata and osteoarticular symptoms. Hautarzt 1997; 48:186-190.
https://doi.org/10.1007/s001050050568
23. Bolukbas N, Bolukbas S, Erel A, Tali ET. Sapho syndrome associated with acne fulminans and prominent acromioclavicular joint involvement. Scand J Rheu matol 1996; 25:180-182.
https://doi.org/10.3109/03009749609080012
24. Jana H, Pavel K. The SAPHO syndrome in a 16 year old boy: coincidence of acne conglobata and osteoarthritis. J Adolesc Health 1993; 14:120-123.
https://doi.org/10.1016/1054-139X(93)90096-8
25. Andrews GC, Machacek GF. Pustular bacterides of the hands and feet. Arch Dermatol Syph 1935; 32: 327-347.
https://doi.org/10.1001/archderm.1935.01470060002001
26. Pons JC, Nekhlyudov L, Delfraissy JF. The course of the SAPHO syndrome during pregnancy. Eur J Obstet Gynecol Reprod Biol 1996; 70:215-216.
https://doi.org/10.1016/S0301-2115(95)02588-X
27. Toussirot E, Dupond JL, Wendling D. Spondylodiscitis in SAPHO syndrome. A series of eight cases. Ann Rheum Dis 1997; 56:52-58.
https://doi.org/10.1136/ard.56.1.52
28. Reith JD, Bauer TW, Schils JP. Osseous mani festations of SAPHO (synovitis, acne, pustulosis, hyperostosis, osteítis) syndrome. Am J Surg Pathol 1996; 20:1368-1377.
https://doi.org/10.1097/00000478-199611000-00008
29. Watts RA et al. Arthro-osteitis - a clinical spectrum. BrJRheumatol1993; 32:403-407.
https://doi.org/10.1093/rheumatology/32.5.403
30. Cotten A et al. SAPHO syndrome. Radiographics 1995; 15:1147-1154.
https://doi.org/10.1148/radiographics.15.5.7501856
31. Dihlmann W, Dihlmann SW, Hering L. Acquired hype rostosis syndrome -AHYS-(sternocostoclavicular hyperostosis, pustulotic arthro-osteitis, SAPHO syndrome): bone scintigraphy of the anterior chest wall. Clin Rheumatol 1997; 16:13-24.
https://doi.org/10.1007/BF02238758
32. Olivieri I et al. Ankylosing spondylitis with exuberant sclerosis or SAPHO syndrome? J Rheumatol 1993; 20:202-203.
33. Vignot E, Colson F, Tebib JG, Bouvier M. Vertebral osteosclerosis, sacro-iliitis and palmoplantar derma� titis. Apropos of a case. Ann Radio! París 1992; 35:225-228.
34. Vecchio PC, Marlton PV, Webb J. Noninfectious osteítis: part of the SAPHO syndrome. Clin Rheu matol 1992; 11:371-375.
https://doi.org/10.1007/BF02207195
35. Kahn MF et al. Sternoclavicular pustulotic osteítis (SAPHO). 20 year interval between skin and bone lesions. J Rheumatol 1991; 18:1104-1108.
36. Beraneck L, Kaplan G, Girardet JP. Multifocal recurrent chronic osteítis. Course over 12 years. Correlation with SAPHO syndrome. Rev Rhum Mal Osteoartic 1990; 57:473-475.
37. Konczaty H, Bourrillon A, Hayem F. Rheumatism and acne conglobata. a proposal of a new case in a 13 year old boy. Ann Pediatr Paris 1990; 37:231-234.
38. Schreiber S, Starc JM, Thys P. Rapidly destructive spondylitis, a manifestation of SAPHO syndrome. Rev Rhum Mal Osteoartic 1990; 57:217-219.
39. Collange C, Brantus JF, Sidot C, Meunier PJ. Sapho syndrome with femoral hyperostosis. Two case reports. Rev Rheum Engl Ed 1996; 63:367-370.
40. Kahn MF. SAPHO syndrome. Dermatology 1995; 190:85.
https://doi.org/10.1159/000246643
41. Vohradnikova O et al. The SAPHO syndrome. Acta Derm Venereol 1993; 73:208-209.
42. Kahn MF, Khan MA. The SAPHO syndrome. Baillieres Clin Rheumatol 1994; 8:333-362.
https://doi.org/10.1016/S0950-3579(94)80022-7
43. Brandsen RE et al. SAPHO syndrome. Dermatology 1993; 186:176-180.
https://doi.org/10.1159/000247340
44. Grosshans EM. SAPHO: the impossible acronym. Dermatology 1993; 186:161-162.
https://doi.org/10.1159/000247336
45. Kahn MF, Chamo! AM. SAPHO syndrome. Rheum Dis Clin North Am 1992; 18:225- 246.
46. Crepy Al, Veyssier P, Kaloustian E, et al. SAPHO syndrome. A case report. Ann Med Interne Paris 1990; 141:390-391.
47. Garcia-Marin F, lriarte-Ortabe JI, Reychler H. Chronic diffuse sclerosing osteomyelitis of the mandible or mandibular location of S.A.P.H.O. syndrome. Acta Stomatol Belg 1996; 93:65-71.
48. Kahn MF et al. Chronic enterocolopathies and SAPHO syndrome. 8 cases. Rev Rheum Mal Osteoartic 1992; 59:91-94.
49. Gouldden, B et al. Long-term safety of isotretinoin as a treatment for acne vulgaris. Br J Dermatol 1994; 131:360-363.
https://doi.org/10.1111/j.1365-2133.1994.tb08524.x
50. Margolis DJ et al. Effects of isotretinoin on bone mine- ralization during routine therapy with isotretinoin for acne. Arch Dermatol 1996; 132:769-774.
https://doi.org/10.1001/archderm.1996.03890310053007
Cómo citar
1.
Garzón Aldás E, Garzón Vásconez H, Soria Arteaga L. Síndrome SAPHO - primeros casos en el Ecuador. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 5 de julio de 2019 [citado 3 de julio de 2024];8(2):183-90. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/695
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2019-07-05
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Garzón Aldás E, Garzón Vásconez H, Soria Arteaga L. Síndrome SAPHO - primeros casos en el Ecuador. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 5 de julio de 2019 [citado 3 de julio de 2024];8(2):183-90. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/695
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