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[早期银屑病关节炎的诊断与治疗]

[Diagnosis and therapy of early psoriatic arthritis].

作者信息

Köhm M, Behrens F

机构信息

Centrum für innovative Diagnostik und Therapie Rheumatologie/Immunologie ciri GmbH, Rheumatologie, Klinikum der J.-W.-Goethe-Universität Frankfurt/Main, Sandhöfer Allee 6, 60528, Frankfurt/Main, Deutschland.

出版信息

Z Rheumatol. 2012 Jan;71(1):46-52. doi: 10.1007/s00393-011-0896-1.

Abstract

Early diagnosis of psoriatic arthritis is of importance because an erosive disease is already detectable after a 2-year duration of symptoms. Often psoriatic arthritis cannot easily be detected because of the diversity of disease manifestations in early stages. As up to 30% of psoriasis patients develop psoriatic arthritis an interdisciplinary dermatologic/rheumatologic approach to diagnose findings and treatment decisions would be desirable. Screening tools, such as validated questionnaires allow an early detection and selection of patients with a high probability of psoriatic arthritis even in dermatological care or on a house physician basis. The implementation of the CASPAR criteria as a classification tool for psoriatic arthritis has also improved the diagnosis finding in patients with a recent onset of active musculoskeletal disease. Data from early psoriatic arthritis cohorts illustrate that drug-free remission is rare. An adequate treatment is of importance. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has developed treatment recommendations based on the available evidence for different treatment modalities.

摘要

银屑病关节炎的早期诊断至关重要,因为在出现症状两年后就已能检测到侵蚀性疾病。由于早期疾病表现的多样性,银屑病关节炎往往不易被检测到。高达30%的银屑病患者会发展为银屑病关节炎,因此采用跨学科的皮肤科/风湿科方法来诊断病情并做出治疗决策是可取的。筛查工具,如经过验证的问卷,即使在皮肤科护理或家庭医生的基础上,也能早期发现并筛选出患银屑病关节炎可能性高的患者。将CASPAR标准作为银屑病关节炎的分类工具,也改善了近期出现活动性肌肉骨骼疾病患者的诊断结果。早期银屑病关节炎队列的数据表明,无药物缓解很少见。充分的治疗很重要。银屑病和银屑病关节炎研究与评估小组(GRAPPA)已根据现有证据为不同治疗方式制定了治疗建议。

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