[Anterior thoracic and intervertebral erosive joint diseases associated with palmoplantar pustulosis]

Rev Rhum Mal Osteoartic. 1985 Jun;52(6):391-6.
[Article in French]


The authors report three cases of palmo-plantar pustulosis associated with articular signs: erosive arthritis of the right first sternocostal joint in 2 cases (without hypertrophy of the clavicle or the sternum) and atlanto-occipital arthropathy with marked neck stiffness in another case. The HLA phenotype of one case was: A2 - A9 - B14 - X - DR3 - DR4. A surgical sterno-costal biopsy revealed non-specific inflammatory lesions in 2 cases. In one of these cases, a Corynebacterium sp. was isolated. The clinical course was favourable in response to local antibiotic therapy in one case (follow-up of 8 years) and after treatment with non-steroidal anti-inflammatory agents in 2 cases (follow-up of one to two years). The skin biopsy revealed non-spongiform (and therefore non-psoriatic) unilocular pustulosis, distinguishing this non-bacterial pustulosis from pustular palmo-plantar psoriasis with which it is frequently confused. These cases are similar to the cases of "pustulotic arthro-osteitis" reported by Japanese authors (Sonozaki et al.), which appear to be rare in Europe. They seem to be an early form in a vast range of spondylo-arthropathies including rheumatism and acne conglobata. The aetio-pathogenesis of this syndrome is discussed; one of the cases is strongly suggestive of an infectious origin (Corynebacterium). These lesions do not appear to be a form of reactive arthritis, as the presence of HLA B27 is rare in both the European and the Japanese cases.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arthritis / complications*
  • Arthritis / diagnostic imaging
  • Arthritis, Infectious / complications
  • Atlanto-Occipital Joint* / diagnostic imaging
  • Corynebacterium Infections / complications
  • Female
  • Foot Dermatoses / complications*
  • Foot Dermatoses / pathology
  • Hand Dermatoses / complications*
  • Hand Dermatoses / pathology
  • Humans
  • Joints* / pathology
  • Male
  • Middle Aged
  • Radiography
  • Skin / pathology
  • Sternocostal Joints* / diagnostic imaging
  • Sternocostal Joints* / pathology
  • Suppuration / complications