All::Rheumatology::Diseases::Psoriatic arthropathy
Intro
What is Psoriatic Arthropathy associated with, and how is it classified?
Psoriatic arthropathy is associated with psoriasis and classified as one of the seronegative spondyloarthropathies.
How does Psoriatic Arthropathy correlate with cutaneous psoriasis, and what percentage of patients with skin lesions develop arthropathy?
It correlates poorly with cutaneous psoriasis and often precedes skin lesions. Around 10-20% of patients with skin lesions develop arthropathy.
What are the presentation patterns of Psoriatic Arthropathy?
Symmetric polyarthritis (similar to rheumatoid arthritis), asymmetrical oligoarthritis, sacroiliitis, DIP joint disease, arthritis mutilans.
What are some other signs associated with Psoriatic Arthropathy?
Psoriatic skin lesions, periarticular disease (tenosynovitis, enthesitis, dactylitis), nail changes (pitting, onycholysis).
How is Psoriatic Arthropathy investigated, and what unusual X-ray features are often observed?
X-rays may show coexistence of erosive changes and new bone formation, periostitis, and a 'pencil-in-cup' appearance.
How is Psoriatic Arthropathy managed, and what is notable about its treatment compared to rheumatoid arthritis?
Managed by a rheumatologist, and treatment is similar to rheumatoid arthritis with some differences.
How is mild Psoriatic Arthropathy treated?
Mild cases may be managed with NSAIDs alone.
What is the primary treatment for moderate/severe Psoriatic Arthropathy?
Methotrexate is commonly used, and monoclonal antibodies like ustekinumab and secukinumab are options.
What is apremilast, and how does it work in Psoriatic Arthropathy treatment?
Apremilast is a PDE4 inhibitor that suppresses inflammation.
How does the prognosis of Psoriatic Arthropathy compare to Rheumatoid Arthritis?
Psoriatic Arthropathy generally has a better prognosis than Rheumatoid Arthritis.