Acne conglobata associated with spondyloarthropathy and ankylosis of the wrists.

A 38-year-old man with acne conglobata (AC) presented with generalized arthritis and severe ankylosis of the wrists. We first saw him when he was admitted for an acute flare up of left hip and right ankle arthralgia. He had a history of severe cystic acne which was active for more than 10 years. This had been treated with oral antibiotics, including tetracycline and cephalexin, and topical treatments of chlorhexidine gluconate and keratolytic lotions. He was not taking any treatment when we first saw him. X-rays revealed destructive changes in several axial and peripheral joints. ESR was 108 mm Hr. A diagnosis of AC-associated musculoskeletal syndrome was made. He was treated with naproxen, and symptoms improved.This patient shows that arthropathy in AC can be more serious and disabling than previously recognized. A review of the literature did not reveal any other case of AC associated joint ankylosis. (J Clin Rheumatol 1999;5:169-172).