Syndromes Associated with Acne



   
 
Table 3-2 Syndromes Associated with Acne
 Syndrome Clinical Features
 
PAPA syndrome
 
Pyogenic Arthritis (sterile), Pyoderma gangrenosum, Acne

– Inherited (AD), CD2 binding protein 1 (CD2BP1) mutation; CD2BP1 is a pyrininteracting protein, which is part of inflammatory pathway associated with familial Mediterranean fever, Muckle-Wells syndrome, and familial cold urticaria

– Skin changes typically present near or at puberty
 
HAIR-AN
Hyper Androgenism, Insulin Resistance, Acanthosis Nigricans
 
SAPHO
(Chronic recurrent multifocalosteomyelitis)
 
Synovitis, Acne (conglobata), Pustulosis (palmoplantar), Hyperostosis, Osteitis

– Inflammatory bone changes (commonly involving sternoclavicular joint, spine {spondyloarthropathy} and long bones); peripheral arthritis also common

– 1 st line treatment: bisphosphonates suggested in many case reports and series; other treatments include mainstay therapies for psoriatic arthritis (methotrexate, anti-TNF a agents, etc.)