A case of severe psoriatic arthritis with hands flexion contracture and palmar psoriasis successfully treated with guselkumab.

Indeed, in literature there are studies that have not shown superiority of secukinumab and ixekizumab compared with adalimumab on PsA according to ACR20.6 Hence, treating algorithm selection in PsA patients maybe not always easy. Psoriasis has a prevalence of 2%-4% in western adults, and 20%-30% of psoriasis patients may develop psoriatic arthritis (PsA).1 PsA is an inflammatory musculoskeletal disease, affecting both men and women and usually following psoriasis development; hence PsA screening questionnaires are frequently used for a prompt diagnosis.2 It is a complex disease that affects multiple organ systems including peripheral and axial joints, entheses, skin, and nails. [Extracted from the article]