To the Editor:
I have read with great interest the article by Aljuhani, et al1, regarding a large monocentric case series of patients with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. I fully agree with Aljuhani, et al on the frequent involvement of soft tissues around inflamed bone, with the consequent diagnostic difficulties. SAPHO syndrome, in fact, could be a real diagnostic challenge, and Aljuhani, et al described a significant diagnostic delay; this is important because the diagnostic delay leads to inappropriate investigations and prescriptions. With regard to diagnostic delay, it is worth recalling that skin lesions may not be accounted for when they are episodic or appear after bone lesions2. In 1987, Chamot, et al3 suggested the acronym SAPHO to unify various conditions characterized mainly by osteitis/hyperostotic …
Address correspondence to Dr. M. Colina; E-mail: m.colina{at}ausl.imola.bo.it