A girl aged 13 years presented with mild subcutaneous vertex tumefaction and localised alopecia (figure A). She was administered bisphosphonate and infliximab for SAPHO syndrome (ie, synovitis, acnea conglobata, pustulosis, hyperostosis, and osteitis), diagnosed 2 years earlier on the basis of multifocal osteitis (ie, long bones metaphysis, pelvis and costal bones, and a vertebra; figure B) and a papulopustular palmar rash. Initial bone biopsy had shown no malignancy, with a positive culture for Propionibacterium acnes—a frequent finding in people with SAPHO syndrome.
Triaille, C., Kokta, V., Powell, J., & De Bruycker, J. J. (2025). Painful scalp nodules in SAPHO syndrome. The Lancet. Rheumatology, 7(7), e519-e520. https://doi.org/10.1016/s2665-9913(24)00161-9 (Original work published 2025)