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Related Experiment Video

Updated: Jul 14, 2026

Measuring Psoriasis Severity at Home

Measuring Psoriasis Severity at Home

Published on: March 1, 2024

Psoriatic onycho-pachydermo periostitis.

Monika Srivastava¹, Gary Solomon, Bruce Strober

¹New York University Department of Dermatology, USA.

Dermatology Online Journal

|May 22, 2007

Summary

Psoriatic onycho-pachydermo periostitis (POPP) is a rare condition causing nail changes and bone inflammation. Early recognition and treatment with methotrexate or anti-TNF agents are key for managing this psoriatic arthritis subset.

Area of Science:

Rheumatology
Dermatology
Orthopedics

Background:

Psoriatic arthritis (PsA) is a chronic inflammatory disease.
Psoriatic onycho-pachydermo periostitis (POPP) is a rare and distinct subset of PsA.
POPP presents with specific nail and bone manifestations.

Observation:

A 46-year-old woman with onycholysis and painful, swollen digits was evaluated.
No other typical signs of psoriasis were noted.
Hand MRI revealed an extensive periosteal reaction of the phalangeal tuft.

Findings:

POPP is characterized by psoriatic onychodystrophy, connective-tissue thickening, and periosteal reaction.
The case highlights the diagnostic challenge of POPP, especially without other psoriatic stigmata.

Related Experiment Videos

Last Updated: Jul 14, 2026

Measuring Psoriasis Severity at Home

Measuring Psoriasis Severity at Home

Published on: March 1, 2024

Imaging confirmed the characteristic periosteal reaction in the phalangeal tuft.

Implications:

Treatment for POPP is challenging, often requiring a multi-faceted approach.
Low-dose methotrexate and anti-TNF-alpha agents show potential benefit.
Alternative biologic and non-biologic disease-modifying antirheumatic drugs (DMARDs) should be considered for refractory cases.