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A 48-year-old man was suffering from psoriasis with psoriatic arthritis for 8 years. His symptoms worsened over the last 3 months and he presented to our hospital with pain and swelling in the knees and ankles, skin lesions over shins, and elbows and discolouration of toenails. He was being treated with methotrexate 15 mg weekly. Examination revealed effusion in both knees. Psoriatic plaques were present over the anterior aspect of the …
Contributors All the authors have contributed equally in the preparation of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.