Abstract
We present a case with psoriatic onychodystrophy, onycholysis, connective tissue thickening above the distal phalanx as well as specific radiologic changes diagnosed as psoriatic onycho-pachydermo-periostitis who responded dramatically to methotrexate with current literature review. In this article, we report a 53-year-old male patient with psoriatic onycho-pachydermo-periostitis who responded dramatically to methotrexate.