VERTEBRAL LESIONS ASSOCIATED WITH PALMOPLANTAR PUSTULOSIS

Spinal lesions were reviewed in 9 patients (3 men and 6 women) who pre sented with palmoplantar pustulosis. Cervical lesions were found in 3 patients and lumbosacral involvement in 7. The duration of disease ave raged 4.8 years. Seven patients had associated sterno-costo-clavicular hyperostotic lesions, and all showed abnormalities in blood tests whi ch suggested chronic inflammation. Vertebral Lesions were assessed as a spondylodiscitis type in 4, single level syndesmophyte-forming type in 1, multiple hyperostosis type in 4, and an ivory vertebra type in 1 . Five patients were treated conservatively and 4 with progressive spo ndylodiscitis type lesions underwent curettage and anterior interbody fusions. At follow-up, all patients improved in both spinal and cutane ous presentations, and 4 who underwent surgery and 1 with tonsillectom y attained complete cure. The vertebral manifestations of palmoplantar pustulosis may vary, but rapidly progressive lesions need surgery for favourable early improvement from the vertebro-cutaneous symptom comp lex.