Literature on Psoriatic Arthritis

Related ArticlesCutaneous psoriasis in a military flight surgeon.

Aviat Space Environ Med. 2006 Feb;77(2):140-4

Authors: Hagen AD, Sulit DJ, Sulit AK

Cutaneous psoriasis is a common, non-infectious, hyperproliferative, papulosquamous, inflammatory skin disease whose pathogenesis is unknown. The course of psoriasis is typically chronic and unpredictable. Psoriasis can range from a small, local pathological area of skin to widespread dermatologic disease, such as generalized pustular psoriasis and erythroderma. Symptoms can range from mildly symptomatic to life threatening. Complications can range from psychological problems to systemic medical disease, such as psoriatic arthritis and inflammatory bowel disease. Treatment options can have adverse side effects which negatively affect multiple organ systems such as the hematological, neurological, and immunological systems. Therefore, psoriasis is a dermatologic disease that should be taken seriously in military aviation. The disease, its complications, and its therapies can interfere with concentration, mission accomplishment, the ability to operate aircraft safely, and compliance with safety equipment use. In this case report, we present the case of a naval flight surgeon who presented with inverse psoriasis and plaque psoriasis, which ultimately became well controlled with topical medications. The flight surgeon was recommended for military aeromedical waivers for psoriasis and chronic medication use. We also review the medical literature on cutaneous psoriasis, discuss its complications, and review its aeromedical implications in military aviation.

PMID: 16491582 [PubMed - indexed for MEDLINE]

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Related ArticlesThe Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT): Results of radiographic analyses after 1 year.

Ann Rheum Dis. 2006 Feb 13;

Authors: Kavanaugh A, Antoni CE, Gladman DD, Wassenberg S, Zhou B, Beutler A, Keenan G, Burmester G, Furst DE, Weisman M, Kalden JR, Smolen J, van der Heijde D

OBJECTIVE: Infliximab is effective in improving signs and symptoms of joint/skin involvement, functional status and quality of life in patients with psoriatic arthritis (PsA). Using data from the IMPACT trial, we assessed infliximab’s (IFX) effect on structural damage in patients with PsA. METHODS: Patients with active PsA were randomly assigned to receive PBO (PBO/IFX) or IFX 5mg/kg (IFX/IFX) at weeks 0, 2, 6, and 14, with the primary endpoint at week 16. The PBO group received IFX loading doses at weeks 16, 18, and 22. Thereafter, all patients received IFX 5mg/kg every 8 weeks through week 50. Hand/feet radiographs were obtained at weeks 0 and 50. Total radiographic scores were determined using the PsA- modified van der Heijde-Sharp (vdH-S) score. The projected annual rate of progression was calculated by dividing the x-ray score by disease duration (years). RESULTS: As reported previously, 65% of IFX- treated patients vs. 10% of PBO-treated patients achieved an ACR20 response at week 16 (p

PMID: 16439444 [PubMed - as supplied by publisher]

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Related ArticlesTreatment of psoriatic arthritis with etanercept, methotrexate, and cyclosporin A.

Clin Ther. 2006 Feb;28(2):251-4

Authors: Gül U, Gönül M, Kiliç A, Erdem R, Cakmak SK, Gündüz H

BACKGROUND: Psoriatic arthritis (PsA) is seen in approximately 5% to 42% of individuals with psoriasis. CASE SUMMARY: A 37-year-old white male weighing 90 kg presented with erythrodermic psoriasis and PsA. The overall duration of PsA was 3 years. Serum levels of glucose, electrolytes, and tumor markers were normal, as were the results of tests of hepatic and renal function and urinalysis. The findings of posteroanterior radiographic examination of the chest were also normal. However, radiographic examination showed porosis and degeneration in the lumbar vertebrae; narrowing of the L2-L3, L3-L4, and L5-S1 spaces; degenerative changes and narrowing of the proximal interphalangeal and distal interphalangeal (DIP) joints; and osseous ankylosis of the DIP joints of the hands. The cutaneous eruption improved with cyclosporin A (CsA) 3.5 mg/kg p.o., but the severity of PsA did not change. Therefore, parenteral methotrexate (MTX) 15 mg/wk and an indomethacin suppository 100 mg/d were added to the regimen. CsA and MTX were continued for 3 months, during which the patient’s PsA symptoms did not abate, based on tender and swollen joint counts, hand-to-floor distance, erythrocyte sedimentation rate, and levels of C-reactive protein (CRP), antistreptolysin O, and rheumatoid factor. Therefore, etanercept 25 mg s.c. twice weekly was added to the regimen. Three weeks after the initiation of this combination, the patient’s arthritis had improved. The visual analog scale score decreased from 9 to 4. Tender and swollen joint counts decreased from 28 and 24 to 15 and 10, respectively. The hand-to-floor distance decreased from 20 to 10 cm. The erythrocyte sedimentation rate and levels of CRP, antistreptolysin O, and rheumatoid factor decreased from 72 mm/h, 162 mg/L, 250 IU/mL, and 304 IU/mL at baseline to 23 mm/h, 64 mg/L, 48 IU/mL, and 56.1 IU/mL, respectively. No change was observed in radiographs of the patient’s back, hands, and feet. Based on the American College of Rheumatology scoring system, the patient showed 50% improvement in disease severity. Etanercept was discontinued at the end of 4 weeks, and maintenance therapy was continued with MTX alone. No adverse events were reported during or after the completion of etanercept therapy. CONCLUSION: In this patient with PsA that was refractory to CsA and MTX, either alone or in combination, the severity of PsA was reduced after 4 weeks of the combined use of etanercept, CsA, and MTX.

PMID: 16678646 [PubMed - indexed for MEDLINE]

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Psoriasis, psoriatic arthritis, or psoriatic disease?

J Rheumatol. 2006 Feb;33(2):210-2

Authors: Scarpa R, Ayala F, Caporaso N, Olivieri I

PMID: 16465649 [PubMed - indexed for MEDLINE]

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Related ArticlesSubjective improvement in patients with psoriatic arthritis after short-term oral treatment with seal oil. A pilot study with double blind comparison to soy oil.

J Rheumatol. 2006 Feb;33(2):307-10

Authors: Madland TM, Björkkjaer T, Brunborg LA, Fröyland L, Berstad A, Brun JG

OBJECTIVE: To investigate effects of short-term oral treatment with seal oil in patients with psoriatic arthritis (PsA). METHODS: Forty-three patients with polyarticular PsA were randomized to receive oral treatment for 2 weeks with either seal oil or soy oil in a double blind controlled trial. Clinical and biochemical variables were assessed at baseline, after treatment, and 4 weeks post-treatment. Patients were allowed to continue nonsteroidal antiinflammatory drugs (NSAID) and disease modifying antirheumatic drugs (DMARD) during the study. RESULTS: Forty patients completed the study, 20 in each treatment group. Patients in the seal oil group reported a significant improvement in global assessment of the disease 4 weeks post- treatment (p

PMID: 16465662 [PubMed - indexed for MEDLINE]

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Related ArticlesAntibodies to cyclic citrullinated peptides in psoriatic arthritis: do classification criteria affect study results?

J Rheumatol. 2006 Feb;33(2):435; author reply 436-7

Authors: Marchesoni A, Lurati A, Desiati F, Rossi V, Battafarano N

PMID: 16465678 [PubMed - indexed for MEDLINE]

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Related ArticlesSubjective improvement in patients with psoriatic arthritis after short-term oral treatment with seal oil. A pilot study with double blind comparison to soy oil.

J Rheumatol. 2006 Feb;33(2):307-10

Authors: Madland TM, Björkkjaer T, Brunborg LA, Fröyland L, Berstad A, Brun JG

OBJECTIVE: To investigate effects of short-term oral treatment with seal oil in patients with psoriatic arthritis (PsA). METHODS: Forty-three patients with polyarticular PsA were randomized to receive oral treatment for 2 weeks with either seal oil or soy oil in a double blind controlled trial. Clinical and biochemical variables were assessed at baseline, after treatment, and 4 weeks post-treatment. Patients were allowed to continue nonsteroidal antiinflammatory drugs (NSAID) and disease modifying antirheumatic drugs (DMARD) during the study. RESULTS: Forty patients completed the study, 20 in each treatment group. Patients in the seal oil group reported a significant improvement in global assessment of the disease 4 weeks post- treatment (p

PMID: 16465662 [PubMed - indexed for MEDLINE]

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Psoriasis, psoriatic arthritis, or psoriatic disease?

J Rheumatol. 2006 Feb;33(2):210-2

Authors: Scarpa R, Ayala F, Caporaso N, Olivieri I

PMID: 16465649 [PubMed - indexed for MEDLINE]

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