Psoriatic arthritis (PsA) Introduction

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Presentation transcript:

Psoriatic arthritis (PsA) Introduction PsA-Iraj Salehi-Abari Psoriatic arthritis (PsA) Introduction Iraj Salehi-Abari MD., Internist Rheumatologist Salehiabari@sina.tums.ac.ir

Psoriasis is a disease of skin and nail: PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail: Typical psoriatic skin lesion: Demarcated erythematous plaque, with Silvery scale, on the Extensor surfaces of elbows & knees, in the scalp, ears, presacral areas, and Palms and soles, perineum, genitalia Auspitz’s sign: Gentle scraping  pinpoint bleeding

Psoriasis is a disease of skin and nail PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail

Psoriasis is a disease of skin and nail PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail

Psoriasis is a disease of skin and nail: PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail:

Psoriasis is a disease of skin and nail: PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail:

Psoriasis is a disease of skin and nail: PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail:

Psoriasis is a disease of skin and nail: PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail:

PsA-Iraj Salehi-Abari Auspitz’s sign:

PsA-Iraj Salehi-Abari Auspitz’s sign:

PsA-Iraj Salehi-Abari Nail lesions: Nail pits Onycholysis Nailbed hyperkeratosis Oil-drop sign Ridging Leukonychia (Mee’s lines) Red spots in lunula

Psoriasis is a disease of skin and nail: PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail:

Psoriasis is a disease of skin and nail: PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail:

Psoriasis is a disease of skin and nail: PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail:

Psoriasis is a disease of skin and nail: PsA-Iraj Salehi-Abari Psoriasis is a disease of skin and nail:

PsA-Iraj Salehi-Abari Psoriatic arthritis: . Introduction: . Arthritis associated with psoriasis . In the past: A variant of RA . After that: A distinct disease: . Negative RF . Asymmetric arthritis, DIP . Axial, Enthesitis . Radiographic, Genetic . It was a “Seronegative Rheumatism” . Now It is an “ usually Seronegative arthritis” . A member of Spondyloarthritis

PsA-Iraj Salehi-Abari Definition: A systemic disease with arthritis Related to Psoriasis Arthritis could be started: After Psoriasis Along with Psoriasis or Before Psoriasis

PsA-Iraj Salehi-Abari Epidemiology: Prevalence: 1-2/1000 Incidence: 6/100,000 Sex: F = M PsA/ Psoriasis: 14% PsA/ Early undifferentiated arthritis: 13% Psoriasis: peak age of onset = 5-15 years PsA: peak age of onset = 30-55 years Race: Caucasians > non-Caucasians

An arthritis in a patient with Psoriasis: PsA-Iraj Salehi-Abari An arthritis in a patient with Psoriasis: . Psoriatic arthritis . Psoriasis coexistent with: . Rheumatoid arthritis . Osteoarthritis . IBD related arthritis . Gouty arthritis

Relation between arthritis and skin or nail lesions PsA-Iraj Salehi-Abari Relation between arthritis and skin or nail lesions Psoriasis before arthritis: 70% Psoriasis after arthritis: 15% Synchronized Psoriasis & arthritis: 15% No direct relationship between the activity and extention of the skin and joint lesions Nail lesion in Psoriatic arthritis: 80-90% Nail lesion in Psoriasis without arthritis: 46%

PsA-Iraj Salehi-Abari