Keywords: Pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome; PSTPIP1-associated inflammatory diseases (PAID); autoinflammatory diseases; adalimumab; tacrolimus Other anti-inflammatory agents are reserved for treatment failures, and dual therapy, except in combination with steroids, is rarely reported for treatment of PAPA syndrome [[3], [6]]. While monotherapy with tacrolimus was considered, a lapse in treatment with adalimumab for 6-8 weeks resulted in a significant flare of PG, suggesting the ongoing need for dual therapy. 8 Holzinger D, Fassl SK, de Jager W, Lohse P, Rohrig UF, Gattorno M. Single amino acid charge switch defines clinically distinct proline-serine-threonine phosphatase-interacting protein 1 (PSTPIP1)-associated inflammatory diseases. [Extracted from the article]