Alleviation of skin lesions and bone pain in patients with SAPHO after tonsillectomy

Objective To evaluate the clinical efficacy of tonsillectomy on skin lesions and bone pain in patients with synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO). Methods Patients with SAPHO who were refractory to conservative treatment and then received tonsillectomy were recruited. The skin lesions were evaluated using palmoplantar pustulosis area and severity index (PPPASI) scoring. The pain was evaluated by the visual analog score (VAS). The scores of PPPASI and VAS at various follow-ups were recorded. Results Forty-four patients (36 women and 8 men) with a median age of 37.3 years were enrolled. One month after tonsillectomy, skin lesions and bone pain disappeared in 10% and 28% respectively. The disappearance rates 12-month post-op, were 62% and 77% respectively. Conclusions Tonsillectomy exhibits inhibition to skin lesions and bone pain in the patients with SAPHO. Tonsillectomy is a potential alternative treatment for the refractory cases.