Psoriatic onycho-pachydermo-periostitis successfully treated with low-dose methotrexate.
BACKGROUND
Psoriatic onycho-pachydermo-periostitis (POPP) is a rare manifestation of psoriatic arthritis that is often misdiagnosed as a nail infection. The treatment for POPP has not yet been established.


METHODS
We present a case of a 67-year-old man who had no psoriatic skin lesions with POPP, characterized by psoriatic nail changes, painful swelling of the distal soft tissues on the great toes and fingers, and enthesopathies of the involved terminal phalanges. The clinical nail and arthritic changes were improved with methotrexate treatment 4 mg weekly for 6 months.


CONCLUSIONS
Methotrexate can be recommended as the first-choice therapeutic agent for patients with POPP.
Department of Dermatology, Surugadai Nihon University Hospital, Tokyo, Japan.
Toyoko
T
Ochiai
Hisayo
H
Washio
Hidetaka
H
Shiraiwa
Masami
M
Takei
Shigemasa
S
Sawada
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D009260:Nail Diseases / Q000188:drug therapy* / Q000473:pathology; D010522:Periostitis / Q000188:drug therapy* / Q000473:pathology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D008727:Methotrexate