PAPA spectrum disorders

G Ital Dermatol Venereol. 2020 Oct;155(5):542-550. doi: 10.23736/S0392-0488.20.06629-8. Epub 2020 Jul 2.

Abstract

Pyogenic arthritis, pyoderma gangrenosum (PG) and acne (PAPA) syndrome is an autosomal dominant autoinflammatory syndrome due to mutations in proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1) gene and presenting with cutaneous and articular manifestations. Other autoinflammatory syndromes caused by mutations in PSTPIP1 gene or characterized by clinical findings overlapping with those found in PAPA syndrome have been recently included in the group of PAPA spectrum disorders. These disorders are PASH (PG, acne and hidradenitis suppurativa [HS]), PAPASH (PASH associated with pyogenic sterile arthritis), PsAPASH (PASH combined with psoriatic arthritis [PsA], PASS (PG, acne, ankylosing spondylitis, with or without HS), PAC (PG, acne and ulcerative colitis [UC]) and PAMI syndrome (PSTPIP1-associated myeloid-related-proteinemia inflammatory syndrome). Except for PAPA and PAMI, no specific pathogenetic mutations have been identified in these syndromes. Dermatologists should be aware that PG, acne and HS may represent cutaneous signs hiding the presence of these rare entities. Systemic corticosteroids, a number of immunosuppressants and biologics, such as interleukin (IL)-1 antagonists and tumour necrosis factor (TNF) α inhibitors, are nowadays therapy for these diseases. A pathogenesis-driven treatment is the near future in the management of these conditions.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris* / diagnosis
  • Acne Vulgaris* / drug therapy
  • Acne Vulgaris* / physiopathology
  • Arthritis, Infectious* / diagnosis
  • Arthritis, Infectious* / drug therapy
  • Arthritis, Infectious* / physiopathology
  • Humans
  • Pyoderma Gangrenosum* / diagnosis
  • Pyoderma Gangrenosum* / drug therapy
  • Pyoderma Gangrenosum* / physiopathology

Supplementary concepts

  • Pyogenic arthritis, pyoderma gangrenosum, and acne