Rosner I A, Richter D E, Huettner T L, Kuffner G H, Wisnieski J J, Burg C G
Ann Intern Med. 1982 Oct;97(4):520-5. doi: 10.7326/0003-4819-97-4-520.
We evaluated 10 patients with hidradenitis suppurative or acne conglobata who developed arthritis. In contrast to patients with acne fulminans and arthritis, all our subjects were adults over 22 years of age; nine were black; and four were women. Nine patients had episodic inflammatory oligoarthritis affecting mainly larger joints of the upper and lower extremities. Eight patients had roentgenographic evidence of peripheral arthritis, four with erosions. Nine had clinical axial arthropathy, but roentgenograms showed abnormalities of the axial skeleton in all 10 patients. Pyoderma gangrenosum, erythema nodosum, conjunctivitis, urethritis, and oral and penile ulcers occurred in some patients. Rheumatoid factor was negative in all patients; the erythrocyte sedimentation rate was elevated in nine; five had chronic anemia; four had circulating immune complexes; and complement components were elevated in four. There was no increased incidence of HLA-B27 or other HLA-B7 cross-reacting antigens. A temporal relation of skin and joint disease activity was suggested. We report a spondyloarthropathy associated with hidradenitis suppurativa and acne conglobata. Clinical and laboratory manifestations suggest the arthropathy may be reactive to chronic cutaneous infection.
我们评估了10例患有化脓性汗腺炎或聚合性痤疮并发展为关节炎的患者。与暴发性痤疮合并关节炎的患者不同，我们所有的受试者均为22岁以上的成年人；9人为黑人；4人为女性。9例患者患有发作性炎症性寡关节炎，主要累及上下肢的大关节。8例患者有外周关节炎的X线证据，4例有骨质侵蚀。9例有临床轴向关节病，但X线片显示所有10例患者的轴向骨骼均有异常。一些患者出现坏疽性脓皮病、结节性红斑、结膜炎、尿道炎以及口腔和阴茎溃疡。所有患者类风湿因子均为阴性；9例患者红细胞沉降率升高；5例有慢性贫血；4例有循环免疫复合物；4例补体成分升高。HLA - B27或其他HLA - B7交叉反应抗原的发生率没有增加。提示皮肤和关节疾病活动存在时间关系。我们报告一种与化脓性汗腺炎和聚合性痤疮相关的脊柱关节病。临床和实验室表现提示该关节病可能是对慢性皮肤感染的反应。
