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. 2025 May 14;36(2):347-349.
doi: 10.31138/mjr.310724.iia. eCollection 2025 Jun.

Psoriatic Onycho-Pachydermo Periostitis (POPP)

Affiliations

Psoriatic Onycho-Pachydermo Periostitis (POPP)

Aline Serfaty et al. Mediterr J Rheumatol. .
No abstract available

Keywords: MRI; POPP; onychodystrophy; psoriatic arthritis; ultrasonography.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
(left). Photograph of the patient’s left forefoot showing nail dystrophy, oedema, and erythema of the interphalangeal joint of the hallux.
Figure 2.
Figure 2.
(right). Conventional radiography of the hallux with anteroposterior (A) and lateral (B) views showing periarticular erosions (arrows in A) and periosteal reaction (arrowheads in B) of the distal phalanx.
Figure 3.
Figure 3.
(left). Ultrasonography of the hallux revealing enthesitis characterised by hyperostosis of the proximal and distal phalanges (arrows in A), and increased thickness and hypoechogenicity of the extensor hallucis longus (arrowheads in B) associated with peritendinous positive Doppler findings adjacent to the tendon’s insertion at the base of the distal phalanx (C). Synovitis of the interphalangeal joint of the hallux (asterisk in B) is also visible.
Figure 4.
Figure 4.
(right). Magnetic resonance imaging of the hallux. (A) Coronal T1-weighted image showing periarticular erosions (arrow) and soft-tissue swelling with intermediate to low signal intensity (arrowhead). Coronal (B) and sagittal (C) fat-suppressed proton density-weighted images depicting extensive bone-marrow oedema in the proximal and distal phalanges of the hallux (asterisks) related to the extensor and flexor enthesis, and oedema and thickening of the nail bed (open arrow in C).

References

    1. Bertero M, Seia Z, Grande CD, Musso L, Palazzini S. Painful 20 fingers’ onychodistrophy. Indian J Dermatol 2011;56(4):415–7. doi: 10.4103/0019-5154.84743 - DOI - PMC - PubMed
    1. Bethapudi S, Halstead J, Ash Z, McGonagle D, Grainger AJ. Test yourself: answer psoriatic onycho-pachydermo periostitis (POPP). Skeletal Radiol 2014;43(3):409–11; 373–4. doi: 10.1007/s00256-013-1682-8 - DOI - PubMed
    1. Horie K, Fujita Y, Hoshina D, Abe R, Shimizu H. Rapid response to clinical symptoms in early psoriatic onycho-pachydermoperiostitis treated with infliximab. Australas J Dermatol 2018;59(1):e78–e79. doi: 10.1111/ajd.12667 - DOI - PubMed
    1. Watabe D, Endoh K, Maeda F, Akasaka T, Endoh M. Childhood-onset psoriatic onycho-pachydermo-periostitis treated successfully with infliximab. Eur J Dermatol 2015;25(5):506–8. doi: 10.1684/ejd.2015.2616 - DOI - PubMed
    1. Sanal HT, Yilmaz S, Cinar M, Simsek I, Dinc A, Tayfun C. Onychopachydermatit with extensive bone marrow edema predominant in the metacarpals: a “forme fruste” of POPP? Rheumatol Int 2012;32(5):1449–52. doi: 10.1007/s00296-011-1914-y - DOI - PubMed