[WHAT SHOULD BE KNOWN ABOUT PSORIATIC ARTHRITIS]?

Psoriatic arthritis (PsA) is chronic inflammatory arthropathy of peripheral joints and axial skeleton, occurring in 7% to 42% of patients with psoriasis. Arthritis might precede skin psoriatic lesion lesion in 13% to 17% cases. Patients present with pain and stiffness of the affected joins. A genetic factors play an important role (B27 has been associated with axial form, and DR4 with peripheral polyarticular form of PsA). Enthesopathy is a hallmark feature of PsA. It is an inflammation at the sites where tendons and ligaments attach to the bone. Extra-articular manifestations of disease are conjunctivitis and uveitis (occur in up to 1/3 of patients with PsA), heart disorder (aortic insufficiency), gut inflammation, urogenital inflammation. Treatment of PsA includes therapies for boths the skin and the joint disease. The treatment for the joint disease includes using NSAR (nonsteroidal anti-inflammatory drugs), DMARDs (disease-Modifying Antirheumatic Drugs) such as methotrexate (MTX), leflunomid, sulfasalasin and biological agents. Second-line therapy are: systemic glucocorticoids, retinoic acid derivatives/etretinate, photochemoterapy with MTX, physical therapy as an adjunct to drug therapy, and reconstructive surgery. The most important is that rheumatologist and dermatologist need to have some approach in management of PsA for optimal results.