A man in his 37 s consulted about a two-day-history of pustules on his both hands (Fig. 1A-C) and his right elbow (Fig. 1D). He complained also about edema, polyarthralgia with asymmetric small joint involvement and articular impairment in his hands. No other joints were affected. Furthermore, no other skin lesions were advised on clinical examination. He had no associated fever but generalized malaise.
