Rhumatological manifestations of psoriasis

The context: Psoriasic arthritis lies somewhere between rhumatoid polyarthr itis and spondyloathropathy. Its prevalence is about 0.1% with a 1/1 sex ra tio. Mean age at onset of symptoms is 40 years. in 10 to 15% of the cases, rhumatological manifestations are observed before skin lesions. Ungueal inv olvement is particularly frequent. Five clinical forms: Classically, five clinical forms are described: arthri tis limited to the distal interphalangeal joints, mutilating arthritis, sym metrical polyarthritis, asymmetrical mono- or oligoarthritis, and spondylit is. Asymmetrical oligoarticular forms and polyarthrtis predominate. Disease severity: In general psoriasic arthritis is a benign condition. Sev ere forms have however been described with erosion and osteolysis involving the distal inter-phalangeal joints. Typical radiological may be observed. Therapeutic options: Non-steroidal antiinflammatory drugs help control dise ase progression in about one-third of the cases. In other patients, gold sa lts, D-penicillamine, methotrexate, or sulfasalazine may be required.