case_images: PMC10929232_01
case_images: (a) Inflammatory changes and the "bull's head" sign in 99mTc-methylene diphosphonate whole-body bone scintigraphy. (b-m) Cutaneous manifestations. Erythema, pustules, and desquamation on the palms (b and c) and the left sole (d) at baseline. No apparent lesions on the left upper extremity (e) at baseline. Severe pustules and crusts on the palms (f and g) and the left sole (h) during the administration of adalimumab. Erythema on the left upper extremity (i) during the administration of adalimumab. Slight desquamation on the palms (j and k) and the left sole (l) after treatment with secukinumab. Scattered desquamation on the left upper extremity (m) after treatment with secukinumab.
case_images: CCID-17-547-g0001.jpg
case_images: PMC10929232_01_CCID-17-547-g0001.jpg
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case_images: Based on the comprehensive clinical assessment, we diagnosed the patient with SAPHO syndrome (Figure 1a-e).  However, cutaneous lesions worsened and developed psoriasiform rash after 26 days (Figure 1f-i). After treatment with secukinumab, significant improvement in PPP and paradoxical psoriasis were observed, and the patient did not exhibit recurrence of cutaneous manifestations or osteoarticular pain (Figure 1j-m).
case_images: Disease evolution and treatment options of the patient.
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case_images: PMC10929232_01_CCID-17-547-g0002.jpg
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case_images: The changes in disease evolution and treatment options of the patient are shown in Figure 2.