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Tumor Necrosis Factor-α 억제제(Etanercept)로 호전된 Pustulotic Arthro-osteitis

Pustulotic Arthro-osteitis Improved with Anti TNF-α Inhibitor

대한피부과학회지 2019년 57권 7호 p.378 ~ 382
박해석 ( Park Hae-Seok ) - 연세대학교 의과대학 피부과학교실

김종훈 ( Kim Jong-Hoon ) - 연세대학교 의과대학 피부과학교실
김혜원 ( Kim Hye-Won ) - 연세대학교 의과대학 내과학교실
김수찬 ( Kim Soo-Chan ) - 연세대학교 의과대학 피부과학교실


Pustulotic arthro-osteitis (PAO) is a rare chronic inflammatory disorder characterized by inflammatory osteitis of the sternoclavicular joint and palmoplantar pustulosis. Here, we report a case of PAO that was successfully treated with a TNF-α inhibitor. A 45-year-old man presented with a 3-month history of pustular eruption on the palms and soles. Physical examination showed multiple erythematous papulopustules on the palms, back, and left shin, accompanied by sternoclavicular joint swelling and tenderness. Skin biopsy showed intraepidermal pustules filled with neutrophils on the palm. Bone scintigraphy revealed increased uptake in the bilateral sternoclavicular and other axial joints. Based on these findings, we made the diagnosis of PAO. Even after 6-month treatment of oral steroids and cyclosporine, skin manifestations insufficiently improved, so etanercept therapy was started. Complete clearance of skin lesions and joint pain were achieved after 3 months of etanercept therapy.


Pustulotic arthro-osteitis; Anti-TNF-α inhibitor
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