Literature on Psoriatic Arthritis

Related ArticlesThe epidemiology of psoriatic arthritis in Olmsted County, Minnesota, USA, 1982-1991.

J Rheumatol. 2000 May;27(5):1247-50

Authors: Shbeeb M, Uramoto KM, Gibson LE, O’Fallon WM, Gabriel SE

OBJECTIVE: To determine the incidence, prevalence, and outcomes of psoriatic arthritis (PsA) in a geographically defined community. METHODS: Using the Rochester Epidemiology Project computerized medical record system, we screened all records of Olmsted County, Minnesota, residents with any diagnosis consistent with psoriasis and/or PsA made between January 1, 1982 and December 31, 1991. Medical records were reviewed using a pretested data collection form. Only those cases of psoriasis where the diagnosis was confirmed by a dermatologist were included. PsA was defined as inflammatory arthritis associated with a definite diagnosis of psoriasis. All identified cases were followed until death, migration from the county, or January 1, 1992. Cases with seropositive rheumatoid arthritis, systemic lupus erythematosus, crystal induced arthritis, Reiter’s syndrome, arthritis associated with inflammatory bowel diseases, and inflammatory osteoarthritis were excluded. Clinical characteristics were described using summary statistics. Age and sex adjusted incidence and prevalence rates were calculated. Survival was estimated using the Kaplan-Meier method. RESULTs: We reviewed the records of 1844 patients with a diagnosis of psoriasis. In 1056 of these, the diagnosis was confirmed by a dermatologist. Among these 1056 psoriasis cases, we identified 66 cases (34 female, 32 male) of PsA first diagnosed between 1982 and 1991. The average age and sex adjusted incidence rate per 100,000 US population was 6.59 (95% confidence interval, CI, 4.99, 8.19) and the prevalence on January 1, 1992, was about one per 1000 (95% CI 0.81, 1.21). The average age at diagnosis was 40.7 years. At diagnosis, 91, 3, and 6% of cases had oligoarthritis, polyarthritis, and spondylitis, respectively. Over the 477.8 person-years of followup, 25 developed extraarticular manifestations (enthesitis, n = 15; ocular inflammation, n = 11; urethritis, n = 9), 10 patients received disease modifying antirheumatic drug treatment (methotrexate, n = 7; sulfasalazine, n = 5; intramuscular gold, n = 1; oral gold, n = 1), 3 received corticosteroids, and 5 had surgical interventions (synovectomy, n = 3; arthroplasty, n = 1; other reconstructive surgery, n = 2). Survival was not significantly different from the general population (p = 0.546). CONCLUSION: Unlike results from previous referral based studies, our findings indicate that PsA is a mild, uncommon inflammatory arthritis, not associated with a significant increase in mortality.

PMID: 10813295 [PubMed - indexed for MEDLINE]

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Related ArticlesMicroscopic inflammatory changes in colon of patients with both active psoriasis and psoriatic arthritis without bowel symptoms.

J Rheumatol. 2000 May;27(5):1241-6

Authors: Scarpa R, Manguso F, D’Arienzo A, D’Armiento FP, Astarita C, Mazzacca G, Ayala F

OBJECTIVE: To evaluate colonic mucosa of patients with both active psoriasis and psoriatic arthritis (PsA) without bowel symptoms. METHODS: Fifteen persons (9 men, 6 women) who had both active psoriasis and PsA without bowel symptoms underwent colonoscopy with multiple biopsies of bowel mucosa. Ten nonhospitalized healthy subjects in followup colonoscopy after resection of benign polyps (8 men, 2 women) took part as a control group. RESULTS: Six psoriatic patients (40%) showed macroscopically normal colonic mucosa. In the remaining 9 reddening was frequently recorded (6 cases). while edema and granular changes appeared less commonly (3 cases each, respectively). Friability was markedly rare (only one case) and bleeding and ulcerations were absent. All 15 patients showed microscopic changes. Increase in lamina propria cellularity (consisting of plasma cells and lymphocytes) and lymphoid aggregates were found in all cases. Active inflammation, evident as neutrophilic polymorph infiltration occurred in 9 patients. Glandular atrophy was found in 3 cases; mucosal surface changes and crypt abnormalities occurred in one case each. No control had macroscopic or microscopic inflammatory changes of bowel mucosa. CONCLUSION: Bowel mucosa of patients with PsA without bowel symptoms show microscopic lesions even when mucosa appeared macroscopically normal. This result may support a pathogenetic link between skin, joints, and gut in psoriatic patients with arthritis even in the absence of bowel symptoms.

PMID: 10813294 [PubMed - indexed for MEDLINE]

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Related Articles[Hyperaggregation syndrome in patients with osteolytic psoriatic arthritis]

Ter Arkh. 2000;72(5):55-7

Authors: Korotaeva TV, Firsov NN, Vyshlova MA

AIM: To study blood rheology in patients with psoriatic arthritis (PA) having local or advanced osteolysis. MATERIALS AND METHODS: The trial included 16 patients with significant PA and clinical and x-ray symptoms of joint surface osteolysis. Kinetics of red cell aggregation and disaggregation was studied in specially designed erythroagregometer. RESULTS: The assessment of red cell aggregation indicated the presence of hyperaggregation syndrome in the majority of PA patients with associated osteolysis. CONCLUSION: Hyperaggregation may contribute to bone destruction. Its onset can be reviewed as a risk factor for serious destructive changes in the joints.

PMID: 11109623 [PubMed - indexed for MEDLINE]

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The epidemiology of psoriatic arthritis: fact or fiction?

J Rheumatol. 2000 May;27(5):1105-6

Authors: Veale DJ

PMID: 10813271 [PubMed - indexed for MEDLINE]

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