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Interstitial granulomatous dermatitis occurring in a patient with SAPHO syndrome one month after starting leflunomide, and subsequently disappearing with ustekinumab

Interstitial granulomatous dermatitis (IGD) is a rare skin condition, which in half of the cases is associated with rheumatoid arthritis, lupus erythematosus or other inflammatory diseases [1]. Drug causality has been suspected [2-5]. We report a case of IGD occurring during SAPHO syndrome treated for one month with leflunomide (Arava®). Leflunomide was withdrawn with no resolution of IGD, but with exacerbation of rheumatism. Ustekinumab (Stelara®) was started and was associated with the disappearance [...]