Psoriatic Onychopachydermoperiostitis: Improvement with Etanercept

In 2005, a case study reported the successful treatment of Psoriatic onychopachydermoperiostitis (POPP), a variant of psoriatic arthritis, with the anti-TNF antibody etanercept. A 26-year-old male patient with a history of psoriasis presented with pain, swelling, and nail changes in his great toes and left index finger. Despite poor response to antibiotics, after a 6-month treatment with etanercept, the patient experienced significant symptomatic improvement and normalization of nails. This case was the first to report etanercept's benefit for POPP and only the second instance of a TNF inhibitor being effective for this condition. The study highlights the potential of etanercept as a treatment for POPP, a condition previously resistant to other therapies like nonsteroidal anti-inflammatory drugs, methotrexate, retinoids, ciclosporin, and subungual corticosteroid therapy.