3rd July 2023

You see a 25-year-old woman with pain and swelling of her hands. She is complaining of pain in her joints

You see a 25-year-old woman with pain and swelling of her hands. She is complaining of pain in her joints. On examination, there are no visible skin changes, however, you note some abnormalities of her nails, which she states she has had for a few years (see image below).

Observation of patient’s nails

You suspect a diagnosis of psoriatic arthritis.

What nail changes are seen in this photo?

Select the SINGLE most appropriate option from the list below. Select ONE option only.