Rather Shagufta, Nisa Nuzhatun, Arif Tasleem
Department of Dermatology, STDs and Leprosy, Government Medical College, Srinagar, Jammu and Kashmir, India.
N Am J Med Sci. 2015 Aug;7(8):356-61. doi: 10.4103/1947-2714.163643.
The prevalence, clinical presentation, and patterns of psoriatic arthritis (PsA) vary in different parts of the world. The scenario of PsA in west is different from that of Asia. Moreover, the oligoarticular type which was considered most prevalent earlier has been replaced by polyarticular type.
The study was to the clinical profile of psoriasis patients associated with PsA in Kashmir valley of India.
This was a noninterventional, observational, prospective, hospital-based study involving 150 successive patients of PsA over a span of 6 years. Severity of the skin and nail involvement was assessed by Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI), respectively. PsA was diagnosed by classification criteria for PsA. The number and pattern of swollen and tender joints was counted and classified by Moll and Wright's classification criteria.
Plaque-type psoriasis was the most common clinical type, observed in 122 (81.33%) patients followed by erythrodermic psoriasis in 10 (6.66%) patients and pustular psoriasis in eight (5.33%) patients. PsA occurred between 30 and 40 years of age in 105 (70%) patients. The cutaneous involvement occurred before joint involvement in 113 (75.33%), while they occurred simultaneously in 30 (20%) cases and the PsA preceded the skin involvement in seven (4.66%) cases. Symmetrical polyarthritis was the commonest clinical presentation and was seen in 90 (60%) patients. Nail involvement due to psoriasis was present in 120 (80%) patients. Commonest nail change found was pitting and seen in 60 (40%) patients.
The clinical pattern of PsA varies in different parts of the world. Knowledge of the clinical presentation of PsA in a given area is necessary for the successful management of this disease.
银屑病关节炎（PsA）的患病率、临床表现及模式在世界不同地区存在差异。PsA在西方的情况与亚洲不同。此外，先前被认为最常见的少关节型已被多关节型所取代。
本研究旨在了解印度克什米尔山谷地区合并PsA的银屑病患者的临床特征。
这是一项非干预性、观察性、前瞻性、基于医院的研究，在6年时间里连续纳入150例PsA患者。分别采用银屑病面积和严重程度指数（PASI）及甲银屑病严重程度指数（NAPSI）评估皮肤和指甲受累的严重程度。依据PsA分类标准诊断PsA。按照莫尔（Moll）和赖特（Wright）分类标准对肿胀和压痛关节的数量及模式进行计数和分类。
斑块型银屑病是最常见的临床类型，122例（81.33%）患者为此类型，其次是红皮病型银屑病10例（6.66%），脓疱型银屑病8例（5.33%）。105例（70%）患者在30至40岁时发生PsA。113例（75.33%）患者皮肤受累先于关节受累，30例（20%）患者两者同时出现，7例（4.66%）患者PsA先于皮肤受累。对称性多关节炎是最常见临床表现，90例（60%）患者为此表现。120例（80%）患者存在银屑病所致指甲受累。最常见的指甲改变是甲凹点，60例（40%）患者有此表现。
PsA的临床模式在世界不同地区有所不同。了解特定地区PsA的临床表现对于成功治疗该疾病至关重要。
