Psoriasis for six years with rough, red patches on the skin and thickened nails
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There are erosions of the apices and bases of the distal phalanges with erosions of the apex of the intermediate phalanges of the last four toes. Resorption also of the base of the second phalanx of the big toe and of the heads of the first phalanges of all the toes.
Usually the psoriatic arthritis affects the small joints of the hands and feet or large joints (elbows, knees, and ankles) typically asymmetrically.