{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:14:53Z","timestamp":1792797293316,"version":"4.5.0"},"reference-count":176,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Synovitis\u2013acne\u2013pustulosis\u2013hyperostosis\u2013osteitis (SAPHO) syndrome is a rare disease characterized by a sterile inflammatory osteitis and\/or arthritis associated with a wide range of dermatological manifestations, such as acne, palmoplantar pustulosis, and psoriasis. This review, providing up-to-date knowledge on this disease, aims at informing researchers and clinicians to help them program future studies in order to improve patients\u2019 care. Due to the vast clinical heterogeneity that characterizes this disease, SAPHO syndrome has received various names; among these, chronic recurrent multifocal osteomyelitis represents the most used one. The various nomenclatures in use also reflect different approaches to its management. Indeed, considering the world-wide distribution and the vast onset age (from children to late adulthood), in addition to the multiform clinical presentation, its diagnosis and treatment are often challenging for clinicians. In this review, we provide valuable insights on SAPHO syndrome, delving into its many aspects: epidemiology, pathogenesis, clinical presentation, diagnosis, and classification. Most importantly, this paper addresses the continuously changing treatment panorama of this disease, from established drugs to newly introduced ones. Furthermore, a peculiar focus regards nonpharmacologic approaches, including traditional Chinese medicine, the apheresis technique, and surgery. Similarly, this review also discusses patients\u2019 lifestyle, including quality of life. To improve SAPHO syndrome\u2019s management, different knowledge gaps should be filled, such as its current epidemiology and pathogenesis. In turn, perfected knowledge in these fields could also advance research in therapy.<\/jats:p>","DOI":"10.3390\/jcm14041366","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T12:16:37Z","timestamp":1739880997000},"page":"1366","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["What Is New and What Is Next for SAPHO Syndrome Management: A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1074-0861","authenticated-orcid":false,"given":"Mario","family":"Ferraioli","sequence":"first","affiliation":[{"name":"Rheumatology, Immunology and Clinical Allergology Unit, Department of Medicina dei Sistemi, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juela","family":"Levani","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, AOU Careggi, 50121 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2562-887X","authenticated-orcid":false,"given":"Riccardo","family":"De Luca","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, AOU Careggi, 50121 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3710-0569","authenticated-orcid":false,"given":"Caterina","family":"Matucci-Cerinic","sequence":"additional","affiliation":[{"name":"Rheumatology and Autoinflammatory Diseases, IRCCS Istituto Giannina Gaslini; DINOGMI, University of Genoa, 16126 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0704-1916","authenticated-orcid":false,"given":"Marco","family":"Gattorno","sequence":"additional","affiliation":[{"name":"Rheumatology and Autoinflammatory Diseases, IRCCS Istituto Giannina Gaslini; DINOGMI, University of Genoa, 16126 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Guiducci","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, AOU Careggi, 50121 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5926-6263","authenticated-orcid":false,"given":"Silvia","family":"Bellando Randone","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Experimental and Clinical Medicine, University of Florence, AOU Careggi, 50121 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1343-1729","authenticated-orcid":false,"given":"Maria Sole","family":"Chimenti","sequence":"additional","affiliation":[{"name":"Rheumatology, Immunology and Clinical Allergology Unit, Department of Medicina dei Sistemi, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s11832-014-0627-7","article-title":"SAPHO Syndrome: A Review","volume":"9","author":"Rukavina","year":"2015","journal-title":"J. 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