SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD
Bone scintigraphy showed intense activity at the sternoclavicular and first sternocostal joints (Figure 2). Histopathologic examination of the biopsy specimen demonstrated subcorneal neutrophilic pustules with neutrophils in the papillary dermis, but direct immunofluorescence yielded negative results (Figure 3). These findings were consistent with SAPHO syndrome. A 2-month course of oral prednisolone (20 mg/d) and methotrexate (15 mg/wk) led to clinical improvement. A follow-up visit at 2 months after the end of the treatment revealed no recurrence of the lesions.
Palmoplantar Pustulosis Presenting With Chest Pain—Diagnosis. JAMA Dermatol. 2013;149(4):475-480. doi:10.1001/jamadermatol.2013.1998b