Popp syndromeL40.50

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 08.07.2022

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Synonym(s)

Psoriatic onycho-pachydermo-periostitis

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HistoryThis section has been translated automatically.

Fournie 1989

DefinitionThis section has been translated automatically.

POPP is the acronym for "psoriatic onycho-pachydermic periostitis". POPP syndrome is characterized by psoriatic onychodystrophy, connective tissue thickening and periostitis of the distal phalanges (DPs) leading to a drumstick-like deformity. Onycholysis often occurs simultaneously. In a larger series (n=31)the great toes (DPs) were affected in about 70% of cases and the distal interphalangeal joints (DIPs) in about 30%.The damage is often radiographically detectable (Sakellariou GT et al 2021).

Radiologically, there is usually evidence of lamellar periosteal reactions in the acral regions of the affected end phalanges.

Occurrence/EpidemiologyThis section has been translated automatically.

m>w

ManifestationThis section has been translated automatically.

In one larger study (n=31), the mean age was 44.9 years

TherapyThis section has been translated automatically.

The therapy is based on clinical experience in the treatment of psoriatic arthritis (see below Arthritis, psoriatic and psoriasis arthropathica). Initial: disease-modifying antirheumatic drugs(DMARD).

Alterative: sulfasalazine.

If insufficient, consider the use of methotrexate. Methotrexate (MTX) appears to be only moderately effective (Ochiai Tet al. 2006; Sakellariou GT et al. 2021).

Alternative: Success has been achieved with IL-17 inhibitors (secukinumab 150 mg) and TNF-alpha blockers. Case reports exist on adalimumab.

Regarding further treatment of psoriatic onychodystrophy in POPP syndrome, see also Nail psoriasis.

LiteratureThis section has been translated automatically.

  1. Anders HJ et al (2002) Psoriatic onycho-pachydermo periostitis Psoriatic onycho-pachydermo periostitis. Z Rheumatol 61:601-604
  2. Fournie B et al (1989) Psoriatic onycho-pachydermo-periostitis of the big toe: anatomo-clinical study and physiopathogenic approach apropos of 4 cases. Rev Rhum Mal Osteoartic 56:579-582
  3. Goupille P et al (1996) Incidence of osteoperiostitis of the great toe in psoriatic arthritis. J Rheumatol 23: 1553-1556
  4. Ochiai T et al (2006) Psoriatic onycho-pachydermo-periostitis successfully treated with low-dose methotrexate. Med Sci Monit12: CS27 - CS30
  5. Sakellariou GT et al (2021) Psoriatic onycho-pachydermo periostitis (POPP): a case report treated successfully with IL-17 blockade and a literature review on characteristics, pathogenesis, and treatment. Clin Rheumatol 40:4749-4757.
  6. Schilling F(2003) Diskussionsbeitrag zur Kasuistik über die psoriatische Onycho-Pachydermo-Periostitis [Contribution to the discussion of a case of psoriatic onycho-pachydermoperiostitis]. Z Rheumatol 62:206-207.

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Last updated on: 08.07.2022