Category:
(A) The first is the so-called distal interphalangeal arthritis, these patients account for about 10% to 20%, in men, of which 80% of patients will also merge with nail disease, from one to the distal finger were all violated. The current study does not consider it a very specific type of psoriatic arthritis.

(B) The second is a multiple of arthritis, clinical manifestations similar to rheumatoid arthritis, probably accounts for 25% to 60% of patients in the female slightly.

(C) The third is the so-called destruction of the arthritis, patients may present severe joint deformation, bone resorption refers to shorter, or have a similar telescope-like embedded, sleeve of deformation, these patients accounted for 1 percent to five per cent.

(D) The fourth is around the few asymmetric arthritis, violation of not more than four joints to joints as the center, inflammatory fluid leakage to the flexor tendon sheath, rendering the whole finger swelling, looks like a sausage (sausage digit), most such patients are the most common and typical of psoriatic arthritis, about 40% to 55%, and some acute attack of gout will be similar to the way of performance, there are some patients will then gradually evolved into multiple arthritis.

(E) a fifth category for the axial stiffness of arthritis, or way of performance, long-term back pain, neck pain, chest tightness and performance. These patients can be divided into two categories, one is arthritis of the spine accounts for 5 percent to 20 percent, and the other is called the sacroiliac bone inflammation accounted for 10% to 25% of such patients axial and stiffness of arthritis pain than less, rarely alone, often combined with other surrounding arthritis.

The new study’s definition of psoriatic arthritis, expand contacts to include bone lesions in a class of diseases, including the Festival, ligaments, tendons and sarcolemma, and these were often combined with psoriasis symptoms, but there will be no skin symptoms.

Disease name:

About:
In addition to patients with psoriasis will make the skin inflammation, the greater the risk of induced arthritis, two percent, if additional treatment, fingertips in a few years a “bone dissolution.”

Symptoms:
Initial foot joint pain, and after skin peeling, burning, itching skin inflammation, joint problems Caibei diagnosed as psoriatic arthritis.

Causes:
Have not yet know the etiology, but the medical profession in connection with heredity.

Prevention:
If you have any psoriasis symptoms, blood tests immediately, to prevent the occurrence of psoriatic arthritis.

Treatment:
Psoriatic arthritis traditional therapy is taking anti-inflammatory drugs, but failed to inhibit the disease. Furthermore, non-steroid drugs can cause gastrointestinal bleeding, and even liver and kidney function; steroid will cause high blood pressure, diabetes, skin edema, cataracts and other serious side effects. Biological agents Etanercept, Adalinumab, Infliximab is made from the protein. This drug can prevent the immune system disorders and damage due to joint. Foreign studies have shown that patients with sustained, three months after injection, 59% of the disease have been improved significantly. But because the drug suppresses the immune system, doctors recommended only for the moderate to severe disease in patients receiving conventional therapy when used. Heart disease, hepatitis and pneumonia vaccination in high risk patients Dengjun not.

Whether there is seasonal?
No

Cause
Cause of unknown etiology. May be related to genetic, immune, endocrine and metabolic abnormalities, infection, trauma and other relevant.

Pathology
Early synovial hyperemia, edema, inflammatory cell infiltration, followed by synovial cell hyperplasia, hypertrophy, the formation of villi, increased fibrous tissue, vascular wall thickening, stenosis, intra-articular fibrosis.

Diagnostics
1. Clinical performance of a majority of the slow onset.

2. Psoriatic arthritis often seen on the skin, the small number of psoriasis before or simultaneously with the emergence of symptoms and activity level of the same psoriatic lesions. Non-symmetrical arthritis, involving the limbs, large joints, spine and sacroiliac joints, joint swelling, pain, tenderness, morning stiffness, late joint deformities, stiffness, activities, obstacle.

3. The skin damage as a systemic, good hair on the scalp and extensor surfaces of the limbs, especially the elbow, knee position, red papules, plaques or small pustules on a silver-white scales cover to remove the scales and the following films, appear point-like bleeding.

4. Means (toe) A damage, a pasta-shaped depression, longitudinal Qiao, A Su-off and so on.

5. Fever, weight loss, some patients with inflammatory eye disease, inflammatory bowel disease and so on.

Laboratory Tests

1. Blood: mild anemia.

2. Activity period increased ESR. Rheumatoid factor-negative, IgG, IgA increased circulating immune complex-positive.

3. 50%-60% of patients positive for HLA-B27.

4. 10%-20% in patients with elevated serum uric acid.

5. synovial fluid examination revealed white blood cell count up to 1 x 109-15 x 109/L, with neutrophils mainly.

Warp the early detection of joint space can be widened, after the articular surface erosion, joint space narrowing; severe bone destruction, means (toe) may have distal bone Distal Osteolysis, bone thinning, variable tip, forming the first kind of pencil or pencil cap-like change; ligament osteophytes, osteoporosis, joint fusion, such as stiffness or subluxation.

A differential diagnosis of rheumatoid arthritis

1. In order to symmetric polyarthritis, with the metacarpophalangeal joints and proximal interphalangeal joint involvement mainly rheumatoid factor positive.

2. Ankylosing spondylitis: a good hair in young men, most patients appear first performance of Sacroiliac arthritis, X-ray showed that the spine showed bamboo-like change, and psoriatic spondylitis of the spine adjacent to the asymmetric ossification.

3. Reiter syndrome: a typical expression of arthritis, conjunctivitis, urinary tract and the triad of light can be associated with psoriasis-like skin rash, no nail changes.

4. Osteoarthritis: more common in the elderly, often involving a negative significant joints, no fever, anemia and other systemic symptoms, not the normal blood, X-ray showed bone hyperplasia, no bone erosion.

Treatment

A drug treatment, non-steroidal anti-inflammatory drugs: ease symptoms, are often used in enteric-coated aspirin, elimination of pain, piroxicam, ibuprofen and so on.

Antimalarials: For psoriatic arthritis, have a certain therapeutic effect, can cause retinal disease, medication should be regularly checked during the fundus.

Chloroquine 0.25-0.5g/d.
Hydroxychloroquine 0.2-0.4g/d.
Immunosuppressive drugs: generic drugs is difficult to control severe cases choose to apply for psoriasis and arthritis, skin Screenshot are effective, easy to relapse after drug withdrawal. Available methotrexate, Aza, cyclosporine A, etc.

Retinoic acid, trade names psoriasis Ling, 30mg/d, gradually increased to 60-70mg/d, or 6-8 weeks after symptoms improved gradually reduced to 30mg/d to maintain. Pairs of psoriatic lesions and arthritis are valid, pregnant and lactating women is disabled.

Other drugs such as sulfasalazine, triptolide are effective for psoriatic skin lesions and arthritis.

Physical therapy photochemical therapy, also known as psoralen ultraviolet A therapy. Oral 8 – methoxypsoralen 0.6mg/kg, 2 hours after exposure to ultraviolet, 2-3 times/week, with a total cumulative amount of no more than 500-600j/cm2. Surgical treatment of severe joint deformity were, line joints plasty, etc..

Joint functional exercise therapy prognosis is good, about 5% of severe joint deformity.