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We report a case of severe <jats:styled-content style=\"fixed-case\">SAPHO<\/jats:styled-content> syndrome in association with hidradenitis suppurativa and pyoderma gangrenosum in a 27\u2010year\u2010old male. The patient had an initial migratory arthritis affecting the knees, ankles, metacarpophalangeal joints, proximal interphalangeal joints, wrists, shoulder, and lower back, which progressed to a persistent arthritis and swelling at the sternum, shoulders, wrists, hands, feet, and lower back. Radiographic changes were consistent with the diagnosis of <jats:styled-content style=\"fixed-case\">SAPHO<\/jats:styled-content> syndrome. Serum proinflammatory cytokine levels were significantly elevated and improved substantially after 3 months of therapy. Rationale for therapy in this patient was the observation that tumor necrosis alpha antagonists have been successfully used in <jats:styled-content style=\"fixed-case\">SAPHO<\/jats:styled-content> syndrome, and since arthropathy was so prominent in our patient, we elected to use adalimumab combined with methotrexate.<\/jats:p>","DOI":"10.1111\/ijd.13740","type":"journal-article","created":{"date-parts":[[2017,9,8]],"date-time":"2017-09-08T10:53:44Z","timestamp":1504868024000},"page":"10-18","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["<scp>SAPHO<\/scp> syndrome associated with hidradenitis suppurativa and pyoderma gangrenosum successfully treated with adalimumab and methotrexate: a case report and review of the literature"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9412-1433","authenticated-orcid":false,"given":"Dunja A.","family":"Vekic","sequence":"first","affiliation":[{"name":"Department of Dermatology Liverpool Hospital Sydney Australia"},{"name":"Ingham Institute of Applied Medical Research Liverpool, Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Woods","sequence":"additional","affiliation":[{"name":"Department of Dermatology Liverpool Hospital Sydney Australia"},{"name":"Ingham Institute of Applied Medical Research Liverpool, Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lin","sequence":"additional","affiliation":[{"name":"University of New South Wales Sydney Australia"},{"name":"Department of Nuclear Medicine Liverpool Hospital Sydney Australia"},{"name":"Western Sydney University Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey D.","family":"Cains","sequence":"additional","affiliation":[{"name":"Ingham Institute of Applied Medical Research Liverpool, Sydney Australia"},{"name":"University of New South Wales Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140342"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2016.04.030"},{"key":"e_1_2_5_4_1","first-page":"187","article-title":"Acne\u2010pustulosis\u2010hyperostosis\u2010osteitis syndrome. 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