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Psoriatic onycho-pachydermo-periostitis successfully treated with low-dose methotrexate.

Toyoko Ochiai, Hisayo Washio, Hidetaka Shiraiwa, Masami Takei, Shigemasa Sawada

Med Sci Monit 2006; 12(4): CS27-30

ID: 448916

Background: Psoriatic onycho-pachydermo-periostitis (POPP) is a rare manifestationof psoriatic arthritis that is often misdiagnosed as a nail infection. The treatment for POPP has notyet been established. Case Report: We present a case of a 67-year-old man who had no psoriatic skin lesionswith POPP, characterized by psoriatic nail changes, painful swelling of the distal soft tissues on thegreat toes and fingers, and enthesopathies of the involved terminal phalanges. The clinical nail andarthritic changes were improved with methotrexate treatment 4 mg weekly for 6 months. Conclusions: Methotrexatecan be recommended as the first-choice therapeutic agent for patients with POPP.

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