PMC10285597_01
Clinical findings on initial presentation. (a) and (b) illustrate erythema and swelling of the distal digits, pustules, nail hyperkeratosis, and detachment. Of note, these pictures were taken following intralesional corticosteroids injection and ultrapotent topical corticosteroid use.
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Upon presentation to our clinic, painful erythema and swelling were noted on all distal digits (hands worse than feet) with associated sterile pustules and/or collarette scales (Figure 1).
Clinical finding after > 1 year of treatment. (a) and (b) show complete remission of skin and nail disease.
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In June 2023 (21 months of treatment), he remained completely controlled (Figure 2(a) and (b)).