PMC9876693_01
(a) Multiple pustular acne over back, (b) acnes healing with hyperpigmentation and scar, (c) few acnes with oily skin of face (d) pustular rashes over forearm with wrist synovitis and bony swelling, (e) active synovitis in knee with black pustules on leg.
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On examination, he had active synovitis in both knees, wrist, elbow and sternoclavicular joints, multiple acneiform and pustular lesions over the chest, back, face, and upper and lower limbs (Figure 1).
(a) X-ray right forearm (both radius and ulna) showing hyperostosis with few lytic area, (b) X-ray knee (AP) showed bilateral tibia periosteal reaction, hyperostosis, osteolysis with osteopenia, (c) Lytic lesions and hyperostosis increased after 1 year during replace, (d) increased sclerotic lesion, lytic lesion with osteopenia after 1 year during relapse. Plain arrow-sclerotic lesion, dotted arrow-lytic lesion.
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Imaging of both knees and forearm showed evidence of subchondral hyperostosis with arthritis changes (Figure 2).
Showing uveitis in right eye complicated with posterior synechiae, poorly dilated pupil and complicated cataract.
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Four months later, he developed acute onset right eye painful redness with the blurring of vision and was diagnosed as acute anterior granulomatous uveitis with posterior synechiae formation (Figure 3).