PMC7779316_01
Clinical manifestation of PA. Dactylitis on all fingers of the right and left hands.
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Physical examination showed swelling, pain, and rigidity of both fingers, knees, and ankles, with dactylitis on the second, third, and fourth fingers of both hands (Figure 1).
Clinical manifestation of OP. Erythematous plaques with hyperkeratotic scales resembling an oyster shell.
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Erythematous plaques with hyperkeratotic scales resembling an oyster shell (Figure 2) were observed almost all over the body, with involvement of 8% of total body surface area.
Histopathological findings (H&E staining 100x). Histopathological results revealed hyperkeratosis, parakeratosis, and Munro's microabscess.
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Histopathological examination of hyperkeratotic lesion from the body revealed psoriasiform reaction with hyperkeratosis, parakeratosis, and Munro's microabscess (Figure 3) that supported the diagnosis of OP.
Clinical manifestation of OP and PA before and after treatment. Significant improvements on joints involved and the skin lesions occurred on day 44 of observation, with reduced pain and swelling on the joints involved as well as resolution of skin lesions.
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Clinical improvement was started on day 28 of observation and significant improvements on the joints involved and skin lesions occurred on day 44 of observation, with reduced pain and swelling on the joints involved as well as resolution of skin lesions (Figure 4).