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Case 19 

Case 19
Chapter:
Case 19
Author(s):

Joel David

, Anne Miller

, Anushka Soni

, and Lyn Williamson

DOI:
10.1093/med/9780199587506.003.0019
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date: 14 August 2018

A 47-year-old nurse was referred with a 3-month history of dry eyes and mouth and aching upper-arm muscles, and a 3-day history of left-sided facial weakness. For the previous year she had been suffering from fatigue, poor sleep, and non-specific joint pains. Six months previously she had developed a pustular psoriatic rash on her palms and feet, resistant to topical treatments.

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