Subclinical joint inflammation in patients with psoriasis without concomitant psoriatic arthritis: a cross-sectional and longitudinal analysis Francesca Faustini,. (C) Number of patients with psoriasis with synovitis and osteitis in the equivalent joint regions. Ustekinumab has significantly improved active psoriatic arthritis compared with placebo. Many patients with psoriasis develop psoriatic arthritis, a chronic inflammatory disease that afflicts peripheral synovial, axial, and entheseal structures. Many patients with psoriasis develop psoriatic arthritis, a chronic inflammatory disease that afflicts peripheral synovial, axial, and entheseal structures. The fully human monoclonal antibody Ustekinumab ( Stelara ) is an efficacious treatment for.
This chronic inflammatory disorder of unknown etiology principally affects the axial skeleton. Alterations occur in synovial and cartilaginous articulations and in sites of tendon and ligament attachment to bone. Pyrophosphate arthropathy: a term used to describe a peculiar pattern of structural joint damage occurring in CPPD crystal deposition disease simulating, in many ways, degenerative joint disease but characterized by distinctive features. Many patients with psoriasis develop psoriatic arthritis, a chronic inflammatory disease that afflicts peripheral synovial, axial, and entheseal structures. The fully human monoclonal antibody ustekinumab is an efficacious treatment for moderate-to-severe plaque psoriasis. Psoriatic Arthritis (PsA) is a chronic inflammatory arthropathy of the peripheral joints and axial skeleton, occurring in a subset of patients with psoriasis. The enthesis, composed of fibrocartilage and collagen type II, is a highly vascular structure aimed to absorb and dissipate mechanical stress and appears to be the primary target in PsA. Elevated levels of TNF-a are found in psoriasis in psoriatic plaques and uninvolved skin alike. First degree relatives of patients with PsA have a 40-50 risk of developing the disease.
Summary Psoriatic arthritis (PsA) is a chronic inflammatory joint disease which develops in patients with psoriasis. Etiology of the disease is still unclear but a number of genetic associations have been identified. It commonly affects the skin and musculoskeletal system causing psoriasis, peripheral arthritis, axial arthritis, enthesitis and dactylitis. Psoriatic arthritis (PsA) is a unique type of inflammatory arthritis that is associated with skin psoriasis. Psoriatic arthritis can affect the joints and surrounding structures such as the tendons and ligaments, specifically as dactylitis and enthesitis. Initial therapy for PsA involving peripheral and axial disease is NSAIDs. Structural changes of bone and cartilage are a hallmark of inflammatory joint diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Bone and cartilage damage is rapid and dynamic after disease onset and affects the majority of RA patients within the first year 8. Moreover, patients with axial disease have more severe peripheral joint disease 47.
It was also recognised in paediatric inflammatory disease as part of the seronegative enthesopathy and arthritis (SEA) syndrome. Imaging of small joints in osteoarthritis and psoriatic arthritis shows that enthesis-related abnormalities are common to both conditions; changes are qualitatively similar in the two but quantitatively greater in the primary inflammatory disorders (Figure 1). A significant number of patients with psoriasis, but without any musculoskeletal symptoms, have subclinical entheseal abnormalities. The inflammation involving the entheses, called enthesitis, is an early inflammatory change seen in psoriatic arthritis, and nail changes appear to result from the close relationship between the nail and the enthesis of the distal interphalangeal extensor tendon, one of the main entheseal compartments affected in psoriatic arthritis.