ABSTRACT
A middle aged man presented with a 4 year history of painful swelling of both knees and pustular acne on his back. The MRI scan of the knees showed gross synovitis, so did the histopathology of the synovium. A diagnosis of SAPHO syndrome was made and he was treated with IV pamidronate. His pain reduced and acne completely cleared up on therapy. A dermatologist has rarely made a diagnosis of SAPHO syndrome and treated it.
Subject(s)
Acquired Hyperostosis Syndrome/diagnosis , Adult , Anti-Inflammatory Agents/therapeutic use , Diphosphonates/therapeutic use , Dose-Response Relationship, Drug , Drug Administration Schedule , Follow-Up Studies , Humans , India , Magnetic Resonance Imaging , Male , Risk Assessment , Severity of Illness Index , Treatment OutcomeABSTRACT
BACKGROUND: Premenstrual acne is poorly understood, the accepted hypothesis is 30 years old. AIMS: Here we test the hypothesis that premenstrual acne can be suppressed using Cox-2 inhibitors. METHODS: Eighty women with premenstrual acne were enrolled in a trial where they were given rofecoxib, a Cox-2 inhibitor or placebo for 10 days for two cycles and were evaluated using acne severity index and inflammatory acne counts. RESULTS: Rofecoxib was more effective than the placebo. CONCLUSIONS: Although the number studied is small, the results suggest that rofecoxib is effective in the management of premenstrual acne and that prostaglandin PGE2 may be involved in its pathogenesis.