The association between axial and peripheral attacks is frequent and favours greatly diagnosis. The sacroiliitis may be asymptomatic, purely and simply radiological. The attack of a distal interphalangeal joint combined with that of the corresponding fingernail is quite distinctive. The existence of a sausage-like toe or finger, in association with articular and synovial attack, is also highly characteristic.
A schematic distinction is made between peripheral and central attacks.
Peripheral attacks are most commonly cases of asymmetrical oligoarthritis affecting one or two large joints as well as a hand joint often combined with tenosynovitis. In 15 to 20% of cases, it may arise as a symmetrical polyarthritis resembling rheumatoid polyarthritis. However, besides the data sourced from the familial questioning and an in-depth skin examination, several characteristics differentiate psoriatic arthritis and rheumatoid arthritis: in psoriatic arthritis, articular attacks are less symmetrical, there is impact on the distal interphalangeal joints - rarely in isolation - there are no subcutaneous nodules, there is often at least some radiological impairment on the sacroiliac joint and the rheumatic serology is negative.
[|In peripheral psoriatic
arthritis, involvement of all joints of one or several fingers or toes should
be differentiated from involvement of several distal interphalangeal joints
(DIPs), the latter often being associated with nail psoriasis.|auteur195]
In 5% of cases we find ourselves confronted with arthritis mutilans, which develops very fast and constitutes a matter of true therapeutic emergency. It is most often observed in a young subject. Generally, it is associated with sacroiliitis and is mostly observed when the skin episode is severe, as well as in certain circumstances such as HIV psoriasis. It may lead to severe disability.
Axial attack is frequent and is encountered in 40% of psoriatic arthritis cases. In half of such cases it is associated with a peripheral attack. Isolated sacroiliitis is possible. This sacroiliitis is often less serious than that observed in ankylosing spondylarthritis. It is often asymmetrical or even unilateral in 30% of cases. It is clinically asymptomatic and visible solely by X-ray in half of cases. It is particularly observed in the male and it is associated with the HLA B27 group in 50 to 70% of cases. Spinal attack is often tardier in developing psoriatic arthritis than in the development of ankylosing spondylarthritis and tends to predominate in the cervicodorsal region.
In the case of pustular psoriasis, particularly the Zumbusch type, activated neutrophilic polynuclears may produce the equivalent of a SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis) and result in joint lysis.
It is also possible, albeit rarely, to observe aseptic osteomyelitis during psoriasis. This manifests itself in the form of muscle and bone pains not relieved by NSAIDs and is located around the long bones, the anterior thorax, the vertebrae and the mandibles.
Finally, it must not be forgotten that uric acid is increased in more than 30% of psoriatics and that gout is not rare.
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Recent publications on Psoriasis and Atopic Dermatitis
on Psoriasis
Conformational dynamics in interleukin 17A and 17F functional complexes is a key determinant of receptor A affinity and specificity.
Cytokine.
2021 Jun , 142:155476.
The proinflammatory cytokines IL-17A and IL-17F have been identified as key drivers of a range of human inflammatory diseases, such as psoriasis, which has led to several therapeutic antibodies targeted at IL-17A. The two cytokines have been shown to tightly associate as functional homo and hetero dimers, which induce signalling via the formation of a cell surface signalling complex with a single copy of both IL-17RA and IL-17RC. Striking differences in affinity have been observed for (...)
see on pubmed
Protective Effects of Polyvinylpyrrolidone-Wrapped Fullerene Against Nitric Oxide/Peroxynitrite-Induced Cellular Injury in Human Skin Keratinocytes.
J Nanosci Nanotechnol.
2021 Sep 01, 21, (9):4579-4585.
Excess ultraviolet (UV) exposure accelerates skin inflammation, melanogenesis, wrinkle formation, photoaging, and carcinogenesis through oxidative stress and deoxyribonucleic acid damage. These deleterious effects to skin are closely associated with UV-induced reactive oxygen species (ROS) and reactive nitrogen species (RNS) produced via nitric oxide (NO) generation. RNS are known to be responsible for various skin disorders, such as erythema, melanin production, reduced barrier function, (...)
see on pubmed
Catalpol ameliorates psoriasis-like phenotypes via SIRT1 mediated suppression of NF-κB and MAPKs signaling pathways.
Bioengineered.
2021 Dec , 12, (1):183-195.
Psoriasis is a chronic inflammatory skin disease that affects approximately 2% of worldwide population, and causing long-term troubles to the patients. Therefore, it is urgent to develop safe and effective therapeutic drugs. Catalpol is a natural iridoid glucoside, that has several remarkable pharmacological effects, however, whether catalpol can alleviated psoriasis has not been explored. The goal of the present work is to study the role of catalpol in psoriasis in vivo and in vitro. (...)
see on pubmed
on Atopic Dermatitis
Viral metagenomic identification of a novel anellovirus in blood sample of a child with atopic dermatitis.
J Med Virol.
2021 Jun , 93, (6):4038-4041.
Here, using viral metagenomics, a novel anellovirus with strain name HuAV-zj-ad1 was detected in blood sample from a child with atopic dermatitis. The complete genome sequence of HuAV-zj-ad1 was determined and fully characterized. The circular genome of HuAV-zj-ad1 is 2841 nt in length and includes four polyprotein ORFs. Phylogenetic analysis and pairwise sequence comparisons based on the amino acid sequences of ORF1, ORF2, ORF3, ORF4 indicated that HuAV-zj-ad1 belonged to a novel species (...)
see on pubmed
Dupilumab therapy for patients with refractory eosinophilic otitis media associated with bronchial asthma.
Auris Nasus Larynx.
2021 Jun , 48, (3):353-360.
Eosinophilic otitis media (EOM) is an intractable otitis media mostly associated with bronchial asthma. Dupilumab, an anti-interleukin (IL)-4 receptor (R)α, is effective and has been approved for use in patients with moderate to severe bronchial asthma, atopic dermatitis and chronic rhinosinusitis with nasal polyposis, whose diseases are not controlled by previous treatments including other molecular targeted drugs. We aimed to assess efficacy of dupilumab in three EOM patients with (...)
see on pubmed
Methicillin-resistant from infected skin lesions present several virulence genes and are associated with the CC30 in Brazilian children with atopic dermatitis.
Virulence.
2021 12 , 12, (1):260-269.
Atopic dermatitis (AD) is a chronic inflammatory skin disease and colonization by may affect up to 100% of these patients. Virulent and resistant isolates can worsen AD patient clinical condition and jeopardize the treatment. We aimed to detect virulence genes and to evaluate the biofilm production of isolates from infected skin lesions of children with AD. Methicillin resistance was detected by phenotypic and molecular tests and the virulence genes were detected by PCR. Biofilm formation (...)
see on pubmed
