amoxicillin-potassium-clavulanate-combination and Acne-Vulgaris

The chronic diffuse sclerosing osteomyelitis (CDSO) of the mandible has been described as an inflammatory disease characterized by recurrent episodes of intense pain in the mandible, often accompanied by trismus, paresthesia and progressive mandibular deformity. The etiopathogeny of this entity is not fully known. The differential diagnosis must be carried out very carefully, and the treatment results are very disappointing. Recently, evidence that suggests that CDSO may be the mandibular location of a more diffuse condition, the synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome, has been offered. We describe two clinical cases of CDSO of typical evolution which fulfill the criteria for SAPHO syndrome, offering us an occasion for a review of the current literature.

Topics: Acne Vulgaris; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Clavulanic Acids; Diagnosis, Differential; Drug Therapy, Combination; Follow-Up Studies; Humans; Hyperostosis; Male; Mandibular Diseases; Middle Aged; Osteitis; Osteomyelitis; Penicillin V; Penicillins; Psoriasis; Sclerosis; Syndrome; Synovitis

For 12 years, a 26-year-old man had acne conglobata and a non-suppurative diffuse sclerosing osteomyelitis of the mandible as part of a chronic recurrent multifocal osteomyelitis of the sternum, the pelvic bones, and the femoral head, and aseptic arthritis of the knee, the fibulotalar, and the sternoclavicular joints. This fulfills the formal criteria of the SAPHO syndrome. Repeated surgical and antibiotic treatment combined with hyperbaric oxygen caused partial improvement. Complete relief and partial disappearance of the scintigraphic lesions was achieved with long-term corticosteroids, non-steroidal anti-inflammatory drugs, minocycline, and isotretinoin.

Topics: Acne Vulgaris; Acquired Hyperostosis Syndrome; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Inflammatory Agents; Dermatologic Agents; Drug Therapy, Combination; Humans; Isotretinoin; Male; Mandibular Diseases; Osteomyelitis; Prednisolone; Radionuclide Imaging

More than 100 years has passed since the first report of a nevus comedonicus. The earliest reports emphasized the inflammatory aspect of the nevus comedonicus as being the most significant problem. In the past 30 years, publications have ignored the inflammatory aspect of nevus comedonicus while emphasizing a variety of associated malformations. In this review, we describe five prepubertal children with prominent and persistent inflammatory changes limited to areas within a nevus comedonicus. In our experience, inflammation can be severe and resistant to treatment. Ultimately, surgical removal of the involved skin was required in two children.

Topics: Acne Vulgaris; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antineoplastic Agents; Cheek; Child; Child, Preschool; Drug Therapy, Combination; Facial Neoplasms; Female; Humans; Infant; Male; Nevus; Shoulder; Skin Neoplasms; Thoracic Neoplasms; Tretinoin