Ms P, Hispanic and now 39 years old, first presented with nonspecific arthritis diagnosed at age 20. She also noted a chronic, watery nasal secretion, which she attributed to a facial injury suffered when she was 7. Her medical history included onychomycosis, gastritis (with positive test for Helicobacter pylori), migraine, and anxiety. Treatment resolved the first 2 conditions; she still occasionally needs therapy for migraine and anxiety.