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To the Editor: Chronic recurrent multifocal osteomyelitis (CRMO) is hypothesized to be an autoimmune disorder because of its association with multiple autoimmune diseases, including inflammatory bowel disease, psoriasis, acne, pustulosis, Sweet syndrome, dyserythropoietic anemia, pyoderma gangrenosum (PG), sclerosing cholangitis, inflammatory arthritis, Still disease, Takayasu arteritis (TA), Ollier disease, and dermatomyositis1,2.PG association with TA is rare; however, Ujiie, et al showed that PG is associated with TA in 33% of patients3.Occurrence of all 3 conditions together (CRMO, PG, and TA) is very rarely reported.A 10-year-old girl born to nonconsanguineous parents presented with a history of intermittent swelling over the right side of the mandible, associated with pain and claudication pain over legs and back with breathlessness on exertion for the past 2 years. She also developed ulcerative cauliflower-like skin lesions over the dorsum of left foot over the past 2 months (Figure 1). On examination, her pulses were absent … Address correspondence to Dr. S. Kumar, Christian Medical College, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu 632004, India. E-mail: sathishkumar{at}cmcvellore.ac.in

An Unusual Association of Chronic Recurrent Multifocal Osteomyelitis, Pyoderma Gangrenosum, and Takayasu Arteritis