LAUSR

clavicular areas but also the peripheral joints have sometimes been encountered. In comparison with patients with psoriatic arthritis, those with PPP with nail deformities rarely complain of distal interphalangeal (DIP) joint pain, and the frequency of such pain is quite low. The findings that, firstly, the frequency of nail involvement differs between PPP and psoriasis, and, secondly, DIP joint pain is rare in PPP suggest that the two disorders are distinct entities. Recently, biologics have been highly effective in the treatment of nail lesions associated with psoriasis and may prove similarly efficient in the treatment of nail lesions in PPP. Alternatively, the most effective therapy for PPP involves treatment of the focal infection. In the present study, two patients with PPP with nail involvement underwent tonsillectomy, and both showed complete improvement. Whether nail involvement is relevant to the severity of PPP is currently under examination.