Literature on Psoriatic Arthritis

Related ArticlesPsoriatic arthritis and synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome.

Curr Opin Rheumatol. 1993 Jul;5(4):428-35

Authors: Kahn MF

Psoriatic arthritis is an inflammatory arthropathy associated with psoriasis, and its clinical presentation varies from case to case. Distal interphalangeal involvement is characteristic but not seen in all patients. Enthesopathy, including that of the spine, is common and contributes to the classification of psoriatic arthritis as a seronegative spondyloarthropathy. The etiopathogenesis of psoriatic arthritis is not well understood, and evolution as measured by follow-up is variable. Treatment includes nonsteroidal anti-inflammatory drugs and some of the drugs used in the treatment of rheumatoid arthritis. Sulfasalazine and, in the more severe cases, cyclosporine, are being studied for efficacy and tolerance. Some cases of psoriatic arthritis are associated with an inflammatory bone disease, frequently seen on the anterior chest wall, which is part of the newly described SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome. SAPHO syndrome is characterized by this bone involvement, which can affect the spine and peripheral bones. Various skin conditions are associated with this syndrome, but they do not necessarily occur in all cases. Chronic recurrent multifocal osteomyelitis, which is seen mostly in children, may be a presentation of SAPHO syndrome. Associations with sacroiliitis, bowel disease, and psoriasis link SAPHO syndrome with the spondyloarthropathies.

PMID: 8357739 [PubMed - indexed for MEDLINE]

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Reduced synovial membrane macrophage numbers, ELAM-1 expression, and lining layer hyperplasia in psoriatic arthritis as compared with rheumatoid arthritis.

Arthritis Rheum. 1993 Jul;36(7):893-900

Authors: Veale D, Yanni G, Rogers S, Barnes L, Bresnihan B, Fitzgerald O

OBJECTIVE. To define the immunohistologic features of the synovial membrane (SM) of patients with psoriatic arthritis (PA) and to compare them with those of an age- and disease-duration-matched population of patients with rheumatoid arthritis (RA). METHODS. Synovial membrane needle biopsy was performed on 15 PA patients with knee involvement (8 had asymmetric oligoarthritis and 7 had symmetric polyarthritis) and on 15 RA controls. Specimens were stained with monoclonal antibodies against T cells (CD3, CD8, CD4, CD45RO), B cells (CD20), macrophages (Mac387, CD14), and cells bearing class II antigens (DAKO-DR). Vascular endothelium was examined using a polyclonal antibody to Factor VIII-related antigen, and adhesion molecule expression was examined using antibodies 1.3B6, 6.5B5, and 1.4C3, which identify endothelial leukocyte adhesion molecule 1 (ELAM-1), intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1), respectively. RESULTS. There was significantly less lining layer hyperplasia, fewer macrophages, and a greater number of blood vessels in PA SM than in RA SM. ELAM-1 expression was less intense in PA than in RA SM, while there was no difference in expression of ICAM-1 and VCAM-1. Numbers of B cells, T cells, and T cell subsets (predominantly CD4, CD45RO T cells) were similar in both groups of patients. CONCLUSION. Our findings demonstrate important differences in the immunohistologic features of PA and RA SM. The PA SM is more vascular, ELAM-1 expression is less intense, and fewer macrophages invade the stroma and migrate to the lining layer than in RA SM. However, the lymphocytic infiltrate in the SM of both groups is similar.

PMID: 7686370 [PubMed - indexed for MEDLINE]

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