History:

A 27-year-old engineer has had plaque psoriasis affected the hands and feet and the extensor surface of both elbows of three years duration. One year after the onset the patient developed psoriatic arthropathy affecting the distal interphalangeal joint of the right little finger with resultant flexion deformity of that joint. At the same time a hard lobulated bony nodule had arisen from the lateral side and planter aspect of the left second toe. Latex test (Rheumatoid factor) was negative and fortunately arthropathic changes were asymptomatic.