Literature on Psoriatic Arthritis

Related ArticlesJuvenile psoriatic arthritis and acquired sensorineural hearing loss in a teenager: is there an association?

Clin Exp Rheumatol. 2006 May-Jun;24(3):344-6

Authors: Giani T, Simonini G, Lunardi C, Puccetti A, De Martino M, Falcini F

Autoimmune inner ear disease is a cause of sensorineural hearing loss, first described in 1979 by McCabe. The occurrence during rheumatic diseases is already documented in adults, but to our knowledge, this evidence is still lacking in children. A 13-yr-old girl affected by juvenile psoriatic arthritis, treated with etanercept, developed a bilateral and asymmetric sensorineural deafness. The patient significantly improved after steroid administration. Once ruled out the principal causes of sensorineural hearing loss, we also considered the hypothesis of an anti-TNF side effect. However, the clinical presentation, the efficacy on steroid treatment and the presence of inner ear auto-antibodies prompt us to consider autoimmune-SNHL as the most plausible diagnosis. The young age of our patient seems to suggest a genetic susceptibility to autoimmunity and supports the concept of associated autoimmune diseases.

PMID: 16870107 [PubMed - in process]

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Related ArticlesJuvenile psoriatic arthritis and acquired sensorineural hearing loss in a teenager: is there an association?

Clin Exp Rheumatol. 2006 May-Jun;24(3):344-6

Authors: Giani T, Simonini G, Lunardi C, Puccetti A, De Martino M, Falcini F

Autoimmune inner ear disease is a cause of sensorineural hearing loss, first described in 1979 by McCabe. The occurrence during rheumatic diseases is already documented in adults, but to our knowledge, this evidence is still lacking in children. A 13-yr-old girl affected by juvenile psoriatic arthritis, treated with etanercept, developed a bilateral and asymmetric sensorineural deafness. The patient significantly improved after steroid administration. Once ruled out the principal causes of sensorineural hearing loss, we also considered the hypothesis of an anti-TNF side effect. However, the clinical presentation, the efficacy on steroid treatment and the presence of inner ear auto-antibodies prompt us to consider autoimmune-SNHL as the most plausible diagnosis. The young age of our patient seems to suggest a genetic susceptibility to autoimmunity and supports the concept of associated autoimmune diseases.

PMID: 16870107 [PubMed - in process]

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Related ArticlesCharcot-like arthropathy: A newly-recognized subset of psoriatic arthritis.

Clin Exp Rheumatol. 2006 Mar-Apr;24(2):172-5

Authors: Candia L, Cuellar ML, Marlowe SM, Marquez J, Iglesias A, Espinoza LR

OBJECTIVE: The aim of the study is to describe a group of patients with a highly destructive and asymptomatic form of psoriatic arthritis, mimicking a Charcot-like joint disease. METHODS: We studied 180 patients with psoriatic arthritis and identified 4 patients with arthritis mutilans mimicking a Charcot-like joint disease. Clinical history, physical exam, and immunological testing were performed as well as X-ray of affected joints. Synovial membrane and sural nerve biopsies were performed and diagnosis of psoriasis was confirmed by skin biopsy. RESULTS: Four patients with psoriatic arthritis mutilans according to Moll and Wright classification criteria (1) and Charcot-like joint disease were identified and evaluated. There were 2 males and 2 females, all Caucasians. The mean age +/- SD was 57.8 +/- 14.2 years. Mean arthritis duration +/- SD was 6 +/- 4.6 years and mean cutaneous duration +/- SD was 13 +/- 10.4 years. All patients had polyarthritis and a sudden onset of bilateral, painless, and highly destructive arthropathy involving large, non-weight bearing (elbows) and weight bearing (knees), and also small joint of hands and feet. Synovial membrane biopsy showed findings similar to those found in Charcot joint disease, including ischemic neuropathy. CONCLUSION: A newly-recognized subset of patients with psoriatic arthritis and Charcot-like joint disease according to clinical, radiographic and histological features is described. The proposed neurovascular theory may explain the pathogenesis of this presentation.

PMID: 16762153 [PubMed - in process]

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Related ArticlesCharcot-like arthropathy: A newly-recognized subset of psoriatic arthritis.

Clin Exp Rheumatol. 2006 Mar-Apr;24(2):172-5

Authors: Candia L, Cuellar ML, Marlowe SM, Marquez J, Iglesias A, Espinoza LR

OBJECTIVE: The aim of the study is to describe a group of patients with a highly destructive and asymptomatic form of psoriatic arthritis, mimicking a Charcot-like joint disease. METHODS: We studied 180 patients with psoriatic arthritis and identified 4 patients with arthritis mutilans mimicking a Charcot-like joint disease. Clinical history, physical exam, and immunological testing were performed as well as X-ray of affected joints. Synovial membrane and sural nerve biopsies were performed and diagnosis of psoriasis was confirmed by skin biopsy. RESULTS: Four patients with psoriatic arthritis mutilans according to Moll and Wright classification criteria (1) and Charcot-like joint disease were identified and evaluated. There were 2 males and 2 females, all Caucasians. The mean age +/- SD was 57.8 +/- 14.2 years. Mean arthritis duration +/- SD was 6 +/- 4.6 years and mean cutaneous duration +/- SD was 13 +/- 10.4 years. All patients had polyarthritis and a sudden onset of bilateral, painless, and highly destructive arthropathy involving large, non-weight bearing (elbows) and weight bearing (knees), and also small joint of hands and feet. Synovial membrane biopsy showed findings similar to those found in Charcot joint disease, including ischemic neuropathy. CONCLUSION: A newly-recognized subset of patients with psoriatic arthritis and Charcot-like joint disease according to clinical, radiographic and histological features is described. The proposed neurovascular theory may explain the pathogenesis of this presentation.

PMID: 16762153 [PubMed - in process]

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Related ArticlesPsoriasis and psoriatic arthritis: immunological aspects and therapeutic guidelines.

Clin Exp Rheumatol. 2006 Jan-Feb;24(1 Suppl 40):S72-8

Authors: Griffiths CE, Iaccarino L, Naldi L, Olivieri I, Pipitone N, Salvarani C, Doria A

Psoriasis is an inflammatory skin disease that affects 1-3% of the European population. Chronic plaque psoriasis, the commonest form of the condition - affecting the majority of patients - usually manifests as red, heavily scaled plaques on elbows, knees, scalp and lower back, but any skin surface may be affected. Psoriasis is associated with an inflammatory sero-negative arthritis, namely “psoriatic arthritis”, in approximately 15%of patients with psoriasis and occurs more commonly in people with inflammatory bowel disease such as patients with Crohn’s disease. Several studies have demonstrated the role of genetic predisposition, innate and adaptive immunity in the pathogenesis of psoriasis. There is considerable evidence that innate immunity and specifically a dysregulation of the innate immune response is central to the development of psoriasis. The role of TNFalpha is particularly intriguing. The evidence includes further observations that a variety of anti-TNF approaches such as monoclonal antibodies and fusion proteins of soluble TNF receptors are effective therapies both in psoriasis and psoriatic arthritis. In this review, in addition to pathogenetic aspects, some preliminary guidelines for the use of anti-TNFalpha therapy in patients with psoriasis and psoriatic arthritis will be discussed.

PMID: 16466629 [PubMed - indexed for MEDLINE]

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Related ArticlesThe assessment of disease activity and outcomes in psoriatic arthritis.

Clin Exp Rheumatol. 2005 Sep-Oct;23(5 Suppl 39):S142-7

Authors: Kavanaugh A, Cassell S

Psoriatic Arthritis (PsA) is a common condition that significantly impacts affected patients. The introduction of novel therapeutic agents for PsA has generated considerable interest in both clinical trials and in clinical care. Thus, there is a great need for standardized outcome measures to assess the activity of disease and the response to therapy. Because psoriasis is a heterogeneous and multi-faceted condition, defining outcome measures has been a challenge. To date, such measures have largely been adapted from related diseases, as described in this essay. Further research is needed to further develop outcome measures for PsA to facilitate optimal treatment of patients with PsA.

PMID: 16273798 [PubMed - indexed for MEDLINE]

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Psoriatic arthritis–pathogenesis and epidemiology.

Clin Exp Rheumatol. 2002 Nov-Dec;20(6 Suppl 28):S27-33

Authors: Veale DJ, FitzGerald O

Psoriatic arthritis (PsA), recognised for over 100 years, is common representing the second most frequent diagnostic category after RA and occurring in up to 10% of patients with skin psoriasis. The pathogenic connection between psoriasis and arthritis is not yet clear although our understanding of the mechanisms of disease has progressed significantly in recent years. Factors including immunogenetics, infection, autoimmunity, angiogenesis, trauma and the nervous system are implicated in the pathogenesis of PsA. Organ involvement is largely restricted to the connective tissue of the skin and joints, including both the synovial tissue and sites of entheseal attachment. This restricted inflammatory response suggests that either a common antigen driving the immune response or that antigenic proteins or cells are present at these sites only having migrated the or arising de novo. The epidemiology of Psoriasis has been extensively examined since the 1960’s, however there have been few large epidemiological studies of PsA. In addition, the lack of diagnostic criteria for the diagnosis of PsA until 1973, and the diffuse clinical manifestations of this condition have hindered meaningful conclusion regarding the epidemiology of this form of arthritis.

PMID: 12463443 [PubMed - indexed for MEDLINE]

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The role of arthroscopy in early arthritis.

Clin Exp Rheumatol. 1999 Jan-Feb;17(1):37-8

Authors: Veale DJ

PMID: 10084026 [PubMed - indexed for MEDLINE]

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Related ArticlesVasculitis and psoriatic arthritis associated with Down’s syndrome.

Clin Exp Rheumatol. 1995 Nov-Dec;13(6):749-51

Authors: Jorgensen C, Bologna C, Sany J

Only a few observations of inflammatory arthritis have been associated with Down’s syndrome. We report a case of severe erosive, peripheral and axial psoriatic arthritis associated with cutaneous vasculitis in a 24-year old man with trisomy 21. A long standing remission of vasculitis and arthritis was achieved with corticoid and azathioprine treatment. The relationship between chromosomal abnormalities and synovial proliferation is further discussed.

PMID: 8835250 [PubMed - indexed for MEDLINE]

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Related ArticlesOn the postulated co-existence of rheumatoid arthritis and psoriatic arthritis.

Clin Exp Rheumatol. 1992 Nov-Dec;10(6):625

Authors: Helliwell PS, Wright V

PMID: 1483318 [PubMed - indexed for MEDLINE]

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