Summary We report the case of a woman with the classic combination of features of synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome, including anterior chest wall involvement and progrediens and transgrediens pustulosis palmo-plantaris. To our knowledge, this late feature has not been reported. The patient was treated with mynocycline and experienced a good evolution, and we conclude that tetracyclines can be a good treatment option for cutaneous manifestations of SAPHO syndrome.