Psoriatic arthritis

Psoriatic arthritis (psoriatic arthritis, PSA; also known as arthropathic psoriasis or psoriatic arthropathy) is a chronic inflammatory joint disease characterized by the presence of arthritis in patients with psoriasis. A total of 1–3% of the population suffers from psoriasis, 42% of them also develop psoriatic arthritis. The disease affects men and women alike. Skin changes precede by joint disease in more than 75% of cases.

Clinical picture
Psoriatic arthritis is classified as a member of spondylarthritises. Characteristic marks are:


 * distal interphalangeal joint (DIJ) damage;
 * diffuse swelling of the affected finger (dactylitis) due to tendosynovitis of the tendons of the finger
 * erosive changes in the joints of the fingers;
 * enthesitis, especially the attachment of the Achilles tendon;
 * severe hand dysfunctions;
 * joint pain;
 * alleviation of warm-up difficulties;
 * more frequent eye difficulties (conjunctivitis, iridocyclitis).

A typical onset is mono or oligoarticular joint difficulties, axial difficulties are usually mild. On X-ray we can find: presence of parasyndesmophytes in the spine, sacroileitis (often common - rather unilateral), also other destructive changes such as those of small joints and periostitis in the area. The laboratory finding is dominated by an increase in sedimentation and CRP. The negativity of rheumatoid factors is important.

Typický začátek je mono nebo oligoartikulární kloubní postižení, axiální postižení bývá mírné. Na RTG nacházíme přítomnost parasyndesmofytů v oblasti páteře a častá je i sakroileitida (spíše jednostranná), dále vídáme destruktivní změny zejména malých kloubů a periostitidy v okolí. V laboratorním nálezu dominuje zvýšení sedimentace a CRP. Důležitá je negativita revmatoidních faktorů.

Occurrence
Psoriatic arthritis most often affects patients around the age of 40. Genetic influences, infectious diseases and the individual's defenses are the main contributors to the development of the disease.

Therapy
Sulfasalazine, methotrexate and leflunomide are mainly used for treatment.

Související články

 * Psoriáza
 * Revmatoidní artritida
 * Ankylosující spondylartritida