DECREASED BONE-MINERAL DENSITY IN PATIENTS WITH PUSTULOSIS PALMARIS ET PLANTARIS

Background: Focal skeletal changes in patients with pustulosis palmari s et plantaris (PPP) are known to occur in a minority of patients. It is unknown whether these changes are unique events or whether they mer ely represent more progressed cases. Objective: The study was undertak en in order to investigate possible diffuse bone changes in patients w ith PPP, Methods: Bone mineral density (BMD) and biochemical markers o f bone turnover were studied in 18 female patients and 18 age-matched controls, Results: A significant correlation was found between lower-f orearm BMD and disease duration (< 0.05), With increasing age, patient s had significantly lower values than controls for both forearm and sp ine BMD (p < 0.005); patients who had PPP for more than 2 years had si gnificantly reduced forearm BMD (19.8%; 95% CI: 5.6-32.8%) and spine B MD (17.4%; 95% CI: 0.9-33.8%). No significant differences were observe d in biochemical markers of bone turnover, physical activity or body m ass index between patients and controls. The proportion of smokers amo ng patients was four times higher than among controls (p < 0.0005), No significant dose effect was found between number of pack-years and BM D, Conclusion: Although we cannot exclude that prolonged use of topica l steroids under occlusion is a confounding factor, the study suggests that PPP patients have decreased BMD due to primary pathogenic events , and that osteoporosis may be an additional problem for these patient s.