PMC4737843_01
Severe 20-nail and nail fold psoriasis before ustekinumab treatment. Fingernails showing relatively less change than the toenails because of the effect of repetitive triamcinolone intralesional injections. Proximal nail fold atrophy caused by steroid injection can be seen.
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F1
Despite these treatments, only minimal improvement was observed on his fingernails, and nail fold atrophy was observed in the fingernail folds (Fig. 1).
Improvement in nail psoriasis after the fourth injection of ustekinumab. There is complete remission of fingernail psoriasis. Both large toenails show subungual hyperkeratosis, which was completely resolved after treatment.
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F2
PIP joints due to PsA was reduced. Psoriasis was almost completely resolved, and the NAPSI score decreased to 7 at week 40 (Fig. 2).