case_images: PMC7666700_01
case_images: hyperpigmented thickened and rough nails
case_images: PAMJ-36-380-g001.jpg
case_images: PMC7666700_01_PAMJ-36-380-g001.jpg
case_images: F1
case_images: On examination there is hyper-pigmented thickened rough nails with sand-paper like appearance in all nails (Figure 1, Figure 2).
case_images: hyperpigmented thickened and rough toe nails
case_images: PAMJ-36-380-g002.jpg
case_images: PMC7666700_01_PAMJ-36-380-g002.jpg
case_images: F2
case_images: On examination there is hyper-pigmented thickened rough nails with sand-paper like appearance in all nails (Figure 1, Figure 2).
case_images: solitary nodule on the elbow
case_images: PAMJ-36-380-g003.jpg
case_images: PMC7666700_01_PAMJ-36-380-g003.jpg
case_images: F3
case_images: There are 2-3 solitary non tender nodules in both elbows measuring about 1-2 cm each (Figure 3).
case_images: hyperkeratosis on the planter surface
case_images: PAMJ-36-380-g004.jpg
case_images: PMC7666700_01_PAMJ-36-380-g004.jpg
case_images: F4
case_images: There is hyperkeratosis of the medial sides of the planter surfaces of the feet (Figure 4).