Abstract
Four cases of chronic arthritis associated with pustulosis palmaris et plantaris are reported. All patients were female, and arthritis was either monoarthritis of the oligoarthritis type or asymmetrical. Synchronous excerbation and remission of skin and joint changes were noted. Destructive changes were not found in roentgenographic examination in the course of the disease. In all cases, laboratory findings showed a moderate elevation of the erythrocyte sedimentation rate, positive CRP and negative serological test for the rheumatoid factor.
The microscopic appearances of the synovial membrane did not differ from those in rheumatoid arthritis. The medical management of this disease was aimed at the suppression of skin lesions and joint inflammation, and most patients with mild to moderate arthritis responded to NASAIDS administration. Tonsillectomy might have had some efficacy in subsiding the arthritis, when the patient had inflamed tonsils, associated with the arthritis.
The etiology and pathogenesis of pustulosis palmaris et plantaris and its associated arthritis remained unclear. There are also no obvious correlations with any certain histocompatibility antigen (HLA B-27) .
