Spondyloarthritis Associated with Acne Conglobata, Hidradenitis Suppurativa and Dissecting Cellulitis of the Scalp: A Review with Illustrative Cases

  • Debbie T. Lim
  • Neena M. James
  • Sobia Hassan
  • Muhammad A. KhanEmail author
Part of the following topical collections:
  1. Topical Collection on Seronegative Arthritis


To review and highlight the association of acne conglobata, hidradenitis suppurativa, and dissecting cellulitis of the scalp with inflammatory arthritic conditions, we report five illustrative patients with this association, and a review of the literature. All our patients were African-American males, and their skin disease present before the onset of arthritis. Both asymmetric peripheral arthritis and axial disease can occur. The arthritis is usually insidious and lacks association with rheumatoid factor and HLA-B27. Imaging of peripheral joints can reveal erosions, periosteal bone reaction and new bone formation. When the axial skeleton is involved, imaging can reveal sacroiliitis, syndesmophyte formation. NSAIDs, oral and intra-articular steroids, DMARDs and TNF alpha antagonists have all been used with success. Controlled trials with larger numbers of patients are needed to assess which treatment options are the most effective for this group of patients.


Ankylosing spondylitis Sacroiliitis Spondyloarthropathy Seronegative arthritis Treatment TNF-inhibitors HLA-B27 Acne conglobata Hidradenitis suppurativa Dissecting cellulitis of the scalp Inflammatory arthritic 


Compliance with Ethics Guidelines

Conflict of Interest

Debbie T. Lim declares that she has no conflicts of interest.

Neena M. James declares that she has no conflicts of interest.

Sobia Hassan declares that she has no conflicts of interest.

Muhammad Asim Khan declares that he has no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Debbie T. Lim
    • 1
  • Neena M. James
    • 1
  • Sobia Hassan
    • 1
  • Muhammad A. Khan
    • 1
    Email author
  1. 1.Division of RheumatologyCase Western Reserve University School of Medicine, MetroHealth Medical CenterClevelandUSA

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