PMC3971542_01
Palmoplantar pustulosis. Multiple pustules over the palms with scaling and erythema.
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F1
After one month, she had new findings of twenty periungal edema, erythema, scale, distorted cuticles, and inflamed proximal nail fold (Fig 1,2).
Nail psoriasis and paronychia - worse. Intense twenty nail proximal nail fold edema with nail plate pitting and onycholysis
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F3
Two months later off adalimumab despite topical corticosteroids, she continued to progress with increased palmoplantar pustules, more intense twenty nail proximal nail fold edema and nail plate pitting, and eventually onycholysis (Fig 3,4).
Nail Psoriasis - improved. Proximal nail clearing and resolution of her paronychia.
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F5
She presented to clinic six months after her initial presentation with proximal nail clearing and resolution of her paronychia. (Fig 5,6).
Palmoplantar pustulosis - resolved.
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F7