银屑病甲-厚皮骨膜炎(POPP)的特征是银屑病甲营养不良,结缔组织增厚,和远端指骨骨膜炎(DPs),产生鼓槌状的畸形。我们的目的是提出用IL-17抑制剂成功治疗的第一例POPP,对其特征和治疗进行文献综述,并探讨其可能的发病机制。我们对以前提出的POPP病例进行了系统回顾。我们介绍了一名甲氨蝶呤(MTX)耐药治疗POPP的患者,在使用苏金单抗150mg的治疗后MRI中,症状和炎性病变显着缓解。我们还在文献综述中确定了31例POPP(男性27例;平均年龄44.9岁)。24例脚趾受累,远端指间(DIP)受累14例,具有频繁的影像学明显损伤。31名患者中有17名接受了生物制剂以外的系统治疗,主要是MTX,没有令人满意的结果。5例成功使用抗TNF药物,主要是在疾病缓解抗风湿药(DMARD)失败后。指甲牛皮癣和DIP型银屑病关节炎的影像学研究表明,指甲之间存在解剖学联系,DP骨,和DIP联合论文,表明POPP可能是DP组织过度受累的指甲疾病的一种亚型(指甲,软组织,Enthesis,和骨头)。IL-17抑制可能是POPP的DMARD抗性病例的替代治疗选择。常规治疗取得了一定的成功,但抗TNF药物似乎更有效。根据影像学研究,POPP可以是指甲疾病的特定亚型。
Psoriatic onycho-pachydermo periostitis (POPP) is characterized by psoriatic onychodystrophy, connective tissue thickening, and periostitis of the distal phalanges (DPs), producing a drumstick-like deformity. Our aim was to present the first
case of POPP treated successfully with an IL-17 inhibitor, perform a literature review of its characteristics and treatment, and explore the possible pathogenesis. We conducted a systematic review of previously presented POPP cases. We present a patient with methotrexate (MTX)-resistant treatment POPP, who had significant resolution of symptoms and inflammatory lesions on post-treatment MRI with secukinumab 150 mg. We also identified 31 cases of POPP (27 males; mean age 44.9 years) in the literature review. There was great toe involvement in 24 cases, and distal interphalangeal (DIP) involvement in 14 cases, with frequent radiographically evident damage. Seventeen of 31 patients received systematic treatment other than biologics, mostly MTX, with no satisfactory results. Anti-TNF agents were used successfully in 5 cases, mostly after disease modifying anti-rheumatic drug (DMARD) failure. Imaging studies in nail psoriasis and DIP psoriatic arthritis have shown an anatomical link among the nail, the DP bone, and the DIP joint entheses, suggesting that POPP may be a subtype of nail disease with excessive involvement of DP tissues (nail, soft tissue, enthesis, and bone). IL-17 inhibition could be an alternative therapeutic option in DMARD-resistant cases of POPP. Conventional treatment achieves modest success, but anti-TNF agents appear to be much more effective. Based on imaging studies, POPP may be a particular subtype of nail disease.