PMC3290118_01
The patient showed psoriatic eruptions on the surface of hemodialysis shunt (A) and on the left knee (B) with hyperkeratosis and discoloration in fingernails (C).
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Approximately 10 months later he noticed eruptions on his head, elbows, fingers and knees with hyperkeratosis and discoloration in his nails, which were clinically diagnosed as psoriasis by a dermatologist, in conjunction with worsening of his systemic arthritis and elevations of CRP (3.31 mg/dL) (Fig. 1).
The clinical profile of the patient.. Note: *Mean +- 2SD in 10 age-matched healthy subjects.. Abbreviations: CRP, C-reactive protein; DAS28, disease activity score including a 28-joint count; IFN, interferon; IL, interleukin; PASI, psoriasis area and severity index; SASP, salazosulfapyridine.
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The patient showed dramatic improvement of his arthritis as well as psoriasis, and DAS28-CRP and PASI decreased to 2.41 and 2.8, respectively, 2 weeks after starting adalimumab (Fig. 2). All of these lymphocyte subpopulations were decreased eight weeks after starting adalimumab compared with before (Fig. 2).