A 61-year-old man with a history of plaque psoriasis of the lower limbs, which was currently in remission, presented with progressively worsening nail dystrophy affecting 8 fingers. His mother had a history of psoriasis.
On physical examination, the nail dystrophy was associated with tender swelling of the distal aspect of the 8 fingers. The toes were spared, and there was no history of psoriatic arthropathy (Figure 1 and Figure 2). Radiographs of the hands were obtained (Figure 3).
Jury CS, Fleming C, Kemmett D. Severe Nail Dystrophy Associated With Painful Fingertips. Arch Dermatol. 2000;136(7):925-930. doi: