Severe Nail Dystrophy Associated With Painful Fingertips
C. S. Jury;
C. Fleming;
D. Kemmett
West Glasgow Hospitals University NHS Trust, Glasgow, Scotland
Arch Dermatol. 2000;136:925-930.
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REPORT OF A CASE
A 61-year-old man with a history of plaque psoriasis of the lower limbs, which was currently in remission, presented with progressively worsening nail dystrophy affecting 8 fingers. His mother had a history of psoriasis.
On physical examination, the nail dystrophy was associated with tender swelling of the distal aspect of the 8 fingers. The toes were spared, and there was no history of psoriatic arthropathy (Figure 1 and Figure 2). Radiographs of the hands were obtained (Figure 3).
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Figure 1.
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Figure 2.
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Figure 3.
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What is your diagnosis?
Diagnosis: Psoriatic onychopachydermoperiostitis (POPP).
Radiologic examination of the hands revealed an exuberant periosteal reaction of the terminal phalanges, with anchor deformation of the terminal phalanx, which was most obvious on the first fingers bilaterally. Calcipotriene was applied twice daily to the periungual skin, with no improvement. Clobetasol propionate ointment was also applied to the same . . . [Full Text of this Article]
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