title: Successful treatment of psoriatic onycho-pachydermo periostitis (POPP) with adalimumab.
abstract: Psoriatic onycho-pachydermo periostitis (POPP) is recognized as a rare subset of psoriatic arthritis, characterized by psoriatic onychodystrophy, connective tissue thickening above the distal phalanx, and a periosteal reaction. Therapy for this rare disease is based on treatments used for psoriatic arthritis, but traditional disease-modifying antirheumatic drugs, such as sulfasalazine and methotrexate, have shown inconsistent and unsatisfactory results. We report herein a successful therapeutic approach for POPP using the fully human anti-tumor necrosis factor (TNF) antibody adalimumab in a 42-year-old male patient. After 4 months of anti-TNF treatment, a remarkable normalization of the clinical appearance was achieved and magnetic resonance imaging showed complete resolution of the initial inflammatory lesions. Therefore, we consider a TNF-blocking strategy as promising for treatment of POPP.
authors.affiliation: University of Regensburg, Regensburg, Germany. bongartz.tim@mayo.edu
authors.forename: T
authors.initials: T
authors.lastname: Bongartz
authors.forename: P
authors.initials: P
authors.lastname: Härle
authors.forename: S
authors.initials: S
authors.lastname: Friedrich
authors.forename: S
authors.initials: S
authors.lastname: Karrer
authors.forename: T
authors.initials: T
authors.lastname: Vogt
authors.forename: A
authors.initials: A
authors.lastname: Seitz
authors.forename: U
authors.initials: U
authors.lastname: Müller-Ladner
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010522:Periostitis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab