Abstract
The 50-year-old patient presented to our clinic for the first time in March 2019, complaining of an altered general condition, inflammatory pain in the small joints of her left hand, right fist and bilateral forefoot, morning stiffness of over 60 minutes, swelling of the right carpal and bilateral metatarsophalangeal joints and finger III left hand dactylitis. The patient is an employee and denies alcohol and tobacco use. From the hereditary antecedents we point a sister diagnosed with psoriasis vulgaris, another sister who died of a gastric neoplasm and her father having cardiovascular diseases.
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