Indian Journal of Dermatology
  Publication of IADVL, WB
  Official organ of AADV
Indexed with Science Citation Index (E) , Web of Science and PubMed
 
Users online: 1167  
Home About  Editorial Board  Current Issue Archives Online Early Coming Soon Guidelines Subscriptions  e-Alerts    Login  
    Small font sizeDefault font sizeIncrease font size Print this page Email this page
CASE REPORT
Year : 2011  |  Volume : 56  |  Issue : 4  |  Page : 415-417

Painful 20 fingers' onychodistrophy


1 MD Ospedale S. Croce e Carle di Cuneo, Diparimnto Specialistico, Italy
2 MD Universitā degli Studi, Pavia, Italy

Correspondence Address:
Zelda Seia
Corso XXIV Maggio 11, Savigliano
Italy
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.84743

Rights and Permissions

Psoriatic onycho-pachydermo-periostitis (POPP) is a rare subset of psoriatic arthritis. It is usually localized to the hands and it is characterized by onychodistrophy, soft tissue thickening above the distal phalanx and periosteal reaction. The resolution is very slow due to the involvement of nails and bone. Low dose methotrexate and anti-tumor necrosis factor-α (anti-TNF-α) agents are the suggested therapies. We report a case of a 53-year-old man affected by palmo-plantar slight psoriatic dermatitis, who presented a rapid onset of POPP. Rx imaging showed enthesitis and a moderate phalanx erosion with articular spaces narrowing and swollen periosteal reaction. A magnetic resonance imaging test of the hands showed an initial stage of synovitis and extensive periostitis of the distal phalangeal tufts. The patient has been treated with oral methotrexate for a month with a rapid clinical improvement and pain reduction. As POPP at first manifests as a painful onycodistrophy, it can easily be confused with bacterial perionyxis. The delay in making the correct diagnosis, and therefore, the delay in giving a proper treatment would mean the progressive articular erosion and the permanent invalidation of the patient's ability to use his hands.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed3212    
    Printed101    
    Emailed1    
    PDF Downloaded43    
    Comments [Add]    

Recommend this journal