Derm Dx: Plaques, joint deformity of the hands

A 45-year-old woman with a previously diagnosed pruritic skin condition presents with significant joint deformity that has developed slowly over the past 10 years. She complains of severe pain in her hands, elbows, knees, ankles, and feet. Examination of skin is positive for erythematous silvery plaques on the dorsal hands, wrists, knees, trunk, and dorsal feet. She is otherwise healthy ...