[Psoriasis. Rheumatologic manifestations].
THE CONTEXT: Psoriasic arthritis lies somewhere between rhumatoid polyarthritis and spondyloathropathy. Its prevalence is about 0.1% with a 1/1 sex ratio. Mean age at onset of symptoms is 40 years. In 10 to 15% of the cases, rhumatological manifestations are observed before skin lesions. Ungueal involvement is particularly frequent. FIVE CLINICAL FORMS: Classically, five clinical forms are described: arthritis limited to the distal interphalangeal joints, mutilating arthritis, symmetrical polyarthritis, asymmetrical mono- or oligoarthritis, and spondylitis. Asymmetrical oligoarticular forms and polyarithrtis predominate. DISEASE SEVERITY: In general psoriasic arthritis is a benign condition. Severe forms have however been described with erosion and osteolysis involving the distal interphalangeal joints. Typical radiological may be observed.
Non-steroidal antiinflammatory drugs help control disease progression in about one-third of the cases. In other patients, gold salts, D-penicillamine, methotrexate, or sulfasalazine may be required.
Service de Médecine interne, Hôpital Louis Mourier, Colombes.
A
A
Grasland
P
P
Vinceneux
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000209:etiology; D011565:Psoriasis / Q000145:classification* / Q000150:complications; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000150:complications
Psoriasis. Manifestations rhumatologiques.