"Retinoic acid participates in limb morphogenesis and induction of differentiation in skin cells and lymphocytes . Topical administration provides therapeutic benefit in dermatologic conditions (Gilchrest 1996); toxic reactions to retinoic acid include arthralgia, arthritis , leukocytoclastic vasculitis, and erythema nodosum (Dubourg et al. 1996; Pfahl and Chytil 1996; De Francesco et al. 1997). A protein involved in retinoic acid signaling or homeostasis is therefore an appealing candidate for the inflammatory processes of PAPA syndrome. "
[Show abstract][Hide abstract] ABSTRACT: Pyoderma gangrenosum, cystic acne, and aseptic arthritis are clinically distinct disorders within the broad class of inflammatory diseases. Although this triad of symptoms is rarely observed in a single patient, a three-generation kindred with autosomal-dominant transmission of these three disorders has been reported as "PAPA syndrome" (MIM 604416). We report mapping of a disease locus for familial pyoderma gangrenosum-acne-arthritis to the long arm of chromosome 15 (maximum two-point LOD score, 5.83; recombination fraction [straight theta] 0 at locus D15S206). Under the assumption of complete penetrance, haplotype analysis of recombination events defined a disease interval of 10 cM, between D15S1023 and D15S979. Successful identification of a single disease locus for this syndrome suggests that these clinically distinct disorders may share a genetic etiology. These data further indicate the role of genes outside the major histocompatibility locus in inflammatory disease.
The American Journal of Human Genetics 05/2000; 66(4):1443-8. DOI:10.1086/302866 · 10.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This report describes the case of a patient with a 14-month course of severe oligoarthritis associated with acne. Pure cultures of Propionibacterium acnes were isolated from synovial tissue and synovial fluid specimens collected from the same joint after a 4-month interval. After 2 months of treatment with roxithromycin 300 mg/day, rifampicin 1,200 mg/day, and a nonsteroidal antiinflammatory drug (NSAID), followed by 4 months of treatment with azithromycin 1 gm/week and and NSAID, the synovitis persisted. Cultures of skin lesions and synovial fluid at this time were negative. Although P acnes has previously been isolated from bone specimens obtained from patients with osteitis associated with acne, this is the first report of the isolation of this microorganism from the synovial tissue of a patient with arthritis associated with acne. Our findings raise the question of the role of P acnes in the pathogenesis of arthritis associated with acne.
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