Methotrexate to Treat SAPHO Syndrome with Keloidal Scars

SAPHO syndrome, a rare condition affecting skin and bones, was diagnosed in a 42-year-old man after years of severe acne and other symptoms. Initially treated with antibiotics and isotretinoin, his condition worsened, leading to keloidal scars and polyarthritis. Methotrexate treatment at 10 mg per week, later increased to 20 mg, resulted in a good clinical response, stabilizing his condition despite previous resistance to other treatments. The case highlighted the challenges in diagnosing SAPHO syndrome and the effectiveness of methotrexate in managing symptoms, even as the skin condition progressed to keloids.