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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 …
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