case_images: PMC10921886_01
case_images: SAPHO syndrome patient with pre-treatment cutaneous manifestation. (a) Scaly erythema, papules, accompanied by pustules ranging from needle tip-to-rice grain size visible in the anterior chest. The postoperative red linear hypertrophic scar was about 10 cm long, and the bean grain size hypertrophic scar was scattered below. (b and c) Scattered red papules, plaques, and scales of varying sizes in both lower extremities. (d) Sole diffuse erythema with lamellar peeling and with needle-tip-to-rice-grain-sized pustules. (e and f) Histopathological examination of a SAPHO syndrome lesion from sole (stained with haematoxylin and eosin; magnifications: (e) x40, (f) x200), revealed mild hyperkeratosis accompanied by parakeratosis and infiltration of neutrophils and lymphocytes in the superficial and intermediate dermis.
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case_images: Both soles exhibited diffuse erythema with lamellar peeling and with needle tip-to-rice grain-sized pustules (Figure 1a-d). Skin biopsy pathology of the sole revealed mild hyperkeratosis accompanied by parakeratosis and infiltration of neutrophils and lymphocytes in the superficial and intermediate dermis (Figure 1e and f). 
case_images: SAPHO syndrome patient with after-treatment skin lesions. (a-d) Erythema, papules, and pustules gradually subsided, leaving slight pigmentation.
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case_images: Following discharge, the dose of baricitinib was halved and continued for three months, with no recurrence or adverse effects observed during the follow-up period (Figure 2a-d).