It is now understood that SAPHO syndrome, which includes synovitis, acne, palmo-plantar pustulosis, hyperostosis, and osteitis, represents a unique medical condition called reactive infectious osteitis. The progression of the illness is thought to be influenced by bacterial, immune, and genetic factors. Non-complete SAPHO symptoms, such as acne and arthritis or acne and anterior wall osteitis with a murky pustulosis history, may make a diagnosis difficult. An important addition to the extensive body of literature demonstrating a relationship between SAPHO and Propionibacterium acnes is the interventional study by Assmann et al. In order to confirm the effects of antibiotic medication, randomised control studies are required.
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