Arthritis mutilans is considered the most severe form of the 5 original clinical patterns of psoriatic arthritis described by Wright and Moll1, but it also has been observed in rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, juvenile idiopathic arthritis, multicentric reticulohistiocytosis, and cutaneous T cell lymphoma2,3,4,5,6,7. We describe a patient with more than 25 years of peripheral inflammatory joint symptoms and findings consistent with arthritis mutilans but without personal …