Tonsilitis prevalent in patients with SAPHO syndrome

A recent study has implicated tonsilitis in synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, with as many as two-thirds of SAPHO patients having the condition, a study has found. Moreover, those with tonsilitis show more severe skin and nail lesions.

The study included 58 SAPHO patients, whose clinical data had been obtained to collect demographic characteristics and acute phase reactants (erythrocyte sedimentation rate, high‐sensitivity C‐reactive protein). Severity of bone pain, skin lesions, and nail lesions were measured using the visual analog scale (VAS), Palmoplantar Pustule Psoriasis Area Severity Index (PPPASI), and Nail Psoriasis Severity Index (NAPSI), respectively.

More than half of the patients (67.2 percent) had tonsillitis. Compared with those who did not, patients with inflammation of the tonsils had markedly higher PPPASI (median, 1.2 vs 7.6; p=0.018) and NAPSI (median, 0 vs 8; p=0.032) scores.

Among patients who underwent tonsillectomy, the procedure resulted in significant improvements from baseline in bone pain (median VAS pain score, 5 vs 3; p=0.034) and skin lesions (median PPPASI score, 16.2 vs 1.8; p=0.028).

The present data highlight the potential of tonsillectomy for improving outcomes in SAPHO patients, particularly bone and skin symptoms. More prospective controlled studies are needed to establish the role of tonsillitis in SAPHO syndrome and the efficacy of tonsillectomy.