[Inflammatory arthritis and osteoarthritis in palmoplantar pustulosis. Case report and review of the literature].

The case of a 46-year-old woman, who had pustulosis palmaris three years ago, and who has been experiencing inflammatory arthritis of the manubriosternal joint for two years with intermittent exacerbations, is reported. The negative bacteriologic investigations and the failure of antibiotic therapy have established that the condition is aseptic. Among patients with a history of palmo-plantar pustulosis, approximately 10% have aseptic inflammatory arthritis or osteitis, most commonly in the anterior chest wall. Other sites are the sacroiliac joints and the spine, where radiological features mimic ankylosing spondylitis, and peripheral joints. Laboratory anomalies are not specific, and HLA B27 antigen is not associated with this syndrome. The course of the arthritis, with exacerbations and remissions, is generally benign. The relationship of this syndrome to psoriatic arthritis is unclear. Non-steroidal antirheumatic drugs are the most effective agents.