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Friday, February 11, 2011

PSORIATIC ARTHRITIS

Psoriasis is a relatively common skin condition. A number of HLA antigens are associated with psoriasis. When psoriatic patients carry the antigen HLA-B27, there is a high risk to develop psoriatic spondylitis. When they are positive for the antigen HLA DR4 they are more liable to develop an arthritis. Psoriatic arthritis a common complication occurring in 5% of psoriatics.


Pathology
In the hands, the DIP joints are prominently involved and associated with psoariatic nail involvement. There is progressive destruction of the articular surface with prominent destruction ( resorption) adjacent to the joint.

Patterns of presentation
Psoriasis: is an inflammatory disease of the skin with erythematous lesions, silvery scales due to increased epidermal proliferation. Genetic, biochemical and dermal factors contribute a lot to psoriasis, Common areas are posterior aspect of elbows, anterior aspect of knees, low back and scalp.

Most common in the age group 30 to 55. The pattern of joint disease is variable and affects both sexes equally.
Group 1 - Classic Psoriatic arthritis
Group 2-  Arthritis mutilans
Group 3- Symmetric polyarthritis
Group 4- Digoarticular arthritis
Group 5- Psoriatic spondylitis

Management

Will be aimed at pain relief and mobility.

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