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[Psoriatic acropachydermy].

M C Marguery1, R Baran, M Pages

  • 1Service de Dermatologie, Hôpital Purpan, Toulouse.

Annales De Dermatologie Et De Venereologie
|January 1, 1991
PubMed
Summary
This summary is machine-generated.

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This case study highlights psoriatic arthritis affecting distal interphalangeal joints and nails. It describes a rare form, psoriatic onychopachydermoperiostitis, linking nail psoriasis to bone and soft tissue changes.

Area of Science:

  • Rheumatology
  • Dermatology
  • Orthopedics

Background:

  • Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis.
  • Distal interphalangeal (DIP) joint involvement is a recognized, though less common, manifestation of PsA.
  • Psoriatic nail disease is prevalent in PsA patients and can precede or accompany joint symptoms.

Observation:

  • A 55-year-old man presented with painful finger changes, including distal enlargement, nail dystrophy, and inflammatory arthralgia of DIP joints.
  • Physical examination revealed significant soft tissue thickening of the ungual phalanges and nail deformities.
  • Radiography confirmed DIP arthritis, osteitis, and periostitis of the ungual phalanges.

Findings:

  • The patient was diagnosed with classical psoriatic arthritis of the DIP type.

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  • The findings were also consistent with psoriatic onychopachydermoperiostitis, a recently described variant of PsA.
  • The case underscores the diagnostic challenges, with initial differential diagnoses including osteoarthritis, pachydermoperiostitis, and acromegaly.

    • Implications:

    • This case illustrates the spectrum of psoriatic arthritis, emphasizing the link between nail and bone pathology.
    • It highlights the importance of recognizing psoriatic onychopachydermoperiostitis for timely diagnosis and management.
    • Understanding this condition can improve diagnostic accuracy for patients with complex digital and nail manifestations potentially related to psoriasis.