{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T12:53:58Z","timestamp":1777726438622,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare autoinflammatory disorder without standardized therapy. Anti-tumor necrosis factor (TNF)-\u03b1 agents, which have been widely used in recent treatment of SAPHO syndrome, may elicit severe paradoxical psoriasiform lesions. Therefore, physicians must reverse the paradoxical skin lesions in affected patients, while improving their clinical symptoms of SAPHO syndrome. Herein, we describe a patient with SAPHO who exhibited TNF-\u03b1 antagonist-induced paradoxical skin lesions and benefitted from treatment with Tripterygium wilfordii hook f (TwHF). A 58-year-old woman with SAPHO developed paradoxical psoriasiform lesions and exacerbation of primary palmoplantar pustulosis after 7 weeks of etanercept treatment. She then received TwHF treatment, which resulted in rapid and remarkable improvement in her skin lesions and osteoarticular pain. These findings suggest that TwHF might be a suitable treatment option for patients with SAPHO who exhibit TNF-\u03b1 antagonist-induced paradoxical skin lesions.<\/jats:p>","DOI":"10.1177\/0300060520949100","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T01:17:34Z","timestamp":1600823854000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Successful treatment of synovitis, acne, pustulosis, hyperostosis, and osteitis and paradoxical skin lesions by\n                    <i>Tripterygium wilfordii<\/i>\n                    hook f: a case report"],"prefix":"10.1177","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7435-2701","authenticated-orcid":false,"given":"Xinlu","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"},{"name":"Institute of Clinical Medicine, Peking Union Medical College Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Peking Union Medical College Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Beijing, 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