Hesni Susan, Khodatars Davoud, Rees Richard, Khanna Monica, Walker Miny
Department of Radiology, Imperial College Healthcare NHS Trust, London, UK.
Department of Rheumatology, Imperial College Healthcare NHS Trust, London, UK.
J Psoriasis Psoriatic Arthritis. 2022 Apr;7(2):93-98. doi: 10.1177/24755303211066089. Epub 2021 Dec 23.
Psoriatic onycho-pachydermo-periostitis (POPP) is an unfamiliar and poorly recognised condition first described in 1989 by Fournie et al. It is a variant of psoriatic arthritis comprising the triad of onycholysis, soft tissue thickening and radiographically apparent periostitis. Whilst typically affecting the great toe, any of the digits of the hands and feet may be affected. A 'drumstick' appearance to the digits of the foot is the most common clinical presentation and can be extremely painful. Nail changes are another hallmark of POPP and can be mistakenly diagnosed as fungal infection leading to lengthy periods of incorrect treatment. In this article, we will outline the clinical presentation, imaging features, pathogenesis and treatment options for POPP. Currently, the existence of POPP is not widely known. Awareness of this unusual condition will allow early appropriate treatment and can aid in the diagnosis of indeterminate seronegative disease.
银屑病性甲厚皮性骨膜炎（POPP）是一种鲜为人知且认识不足的病症，1989年由富尔尼等人首次描述。它是银屑病关节炎的一种变体，包括甲分离、软组织增厚和影像学上明显的骨膜炎三联征。虽然通常影响大脚趾，但手和脚的任何一个手指或脚趾都可能受到影响。足部趾端呈“杵状”外观是最常见的临床表现，且可能极其疼痛。指甲改变是POPP的另一个标志，可能被误诊为真菌感染，导致长期错误治疗。在本文中，我们将概述POPP的临床表现、影像学特征、发病机制和治疗选择。目前，POPP的存在并不广为人知。认识到这种不寻常的病症将有助于早期进行适当治疗，并有助于诊断不确定的血清阴性疾病。
