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Article
February 1996

Psoriatic Onycho-Pachydermo-PeriostitisA Variant of Psoriatic Distal Interphalangeal Arthritis?

Author Affiliations

From the Service de Dermatologie, Hôpital Haut-Lévèque, Bordeaux-Pessac, France (Drs Boisseau-Garsaud, Beylot-Barry, Doutre, and Beylot); and the Nail Diseases Center (Dr Baran), Cannes, France.

Arch Dermatol. 1996;132(2):176-180. doi:10.1001/archderm.1996.03890260078012
Abstract

Background:  Joint and nail involvement in psoriasis is relatively common. In contrast, bony involvement of the terminal phalanx under a psoriatic nail is rare. We report on this psoriatic onycho-pachydermo-periostitis and suggest pathophysiologic mechanisms.

Observations:  Two new cases are reported and the data are compared with the data from eight similar cases reported in the literature. All subjects presented with similar changes— onychopathy, soft-tissue thickening, and radiologic features consisting of bone erosions and a periosteal reaction of the terminal phalanx. Of the 10 patients, two had no history of psoriasis before a diagnosis of psoriatic onycho-pachydermo-periostitis was made. The inflammation is likely transmitted from the psoriatic nail to the adjacent underlying bone by the same mechanism as in enthesopathies.

Conclusion:  Psoriatic onycho-pachydermo-periostitis should be recognized as a specific entity in the spectrum of psoriatic disease.(Arch Dermatol. 1996;132:176-180)

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