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Spondyloarthropathy Associated with Hidradenitis Suppurativa and Acne Conglobata

ITZHAK A. ROSNER, M.D.; DAVID E. RICHTER, M.B., B.S.; TIMOTHY L. HUETTNER, M.D.; GEORGE H. KUFFNER, M.D.; JEFFREY J. WISNIESKI, M.D.; and CAROL G. BURG, M.D.
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Grant support: In part by grant M01RR-80 of the Clinical Research Center, University Hospitals of Cleveland. Dr. Rosner is a recipient of Clinical Investigator Award AM-00773 of the NIADDK.

▸Requests for reprints should be addressed to Itzhak A. Rosner, M.D.; Division of Rheumatology, University Hospitals of Cleveland, 2073 Abington Road; Cleveland, OH 44106.


Cleveland, Ohio


© 1982 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1982;97(4):520-525. doi:10.7326/0003-4819-97-4-520
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We evaluated 10 patients with hidradenitis suppurativa or acne conglobata who developed arthritis. In contrast to patients with acne fulminans and arthritis, all our subjects were adults over 22 years of age; nine were black; and four were women. Nine patients had episodic inflammatory oligoarthritis affecting mainly larger joints of the upper and lower extremities. Eight patients had roentgenographic evidence of peripheral arthritis, four with erosions. Nine had clinical axial arthropathy, but roentgenograms showed abnormalities of the axial skeleton in all 10 patients. Pyoderma gangrenosum, erythema nodosum, conjunctivitis, urethritis, and oral and penile ulcers occurred in some patients. Rheumatoid factor was negative in all patients; the erythrocyte sedimentation rate was elevated in nine; five had chronic anemia; four had circulating immune complexes; and complement components were elevated in four. There was no increased incidence of HLA-B27 or other HLA-B7 cross-reacting antigens. A temporal relation of skin and joint disease activity was suggested. We report a spondyloarthropathy associated with hidradenitis suppurativa and acne conglobata. Clinical and laboratory manifestations suggest the arthropathy may be reactive to chronic cutaneous infection.

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