Psoriatric Arthritis

Overview

In the register of rheumatic diseases in November 2001 a total of 207 patients were on records withthe diagnosis of psoriatic arthritis (PsA)according to Wright and Moll ’s definition of 1973.In thegroup women predominate (F/M =1.38).The mean age of manifestations of psoriasis (ps.)is 30.4 ±15.3 (3.0 –70.0,median 30 years).Psoriasis was most frequently manifested in the second decade (in23.5 %)most frequently the „vulgar “typo of psoriases was involved (91 %).The mean age ofmanifestations of psoriatic arthritis (PsA)is 40.7 ±13.5 years (9.0 –75.0,median 42 years),mostfrequently PsA was manifested in the 5th decade (in 29.8 %).The mean duration of the disease onentry into the register is 10.2 ±8.4 (0.0 –40.0,median 8 years),most frequently 0 –5 years (in 36.0 %).The activity of the disease on a 5 point verbal scale (none,mild,medium,high)very high wasevaluated by the physician most frequently as mild (in 50.2 %),the patients evaluated the activityof the disease most frequently as medium (43.0 %patients),90 %patients in the register have at leastone clinically damaged joint,the mean number of damaged joints per patient is 6.9 ±7.7 (0 –45,median4).The mean rate of progression of articular damage is 1.1 ±1.4 (0 –8,median 0.6)damaged joints peryear.The presence of clinically damaged joints,their number or the rate or progression do notcorrelate with the erythrocyte sedimentation rate (ESR)nor with the level of C-reactive proteinCRP.At least one erosion is present in 65.2 %patients.The presence of erosions does not correlatewith ESR it correlates however positively with the CRP level.The presence of clinical articulardamage correlates positively with the presence of radiological articular damage (with the presenceof erosions).Sacroiliitis is present on X-ray in 24.6 %patients,syndesmophytes and parasyndesmop-hytes are present in 20.7 %patients.Type I PsA (with manifestation of psoriasis before the age of 40years is found in 72.4 %,type II (with manifestation of psoriasis after the age of 40 years)in 27.6 %patients.In PsA type I clinical articular damage is significantly more frequent (p =0.04),the extentof articular damage (i.e.the number of clinically damaged joints)however does not differ signifi-cantly between the two types.The number of patients with erosions does not differ significantly inthe two types of PsA.Ophthalmological manifestations (conjunctivitis or iridocyclitis)were presentin 10.6 %patients,cardiac (aortitis)in 1.5 %and pulmonary also in 1.5 %patients.

Key words:
psoriatic arthritis,psoriasis,clinical articular damage,radiological articular dama-ge,sacroiliitis