Bergman Martin, Lundholm Amy
Taylor Hospital, 8 Morton Avenue, Suite 304, Ridley Park, PA, 19078, USA.
Lankenau Medical Center, Wynnewood, PA, USA.
Arthritis Res Ther. 2017 Mar 20;19(1):63. doi: 10.1186/s13075-017-1265-5.
Psoriatic arthritis is a part of the family of diseases referred to as spondyloarthropathies, a diverse group of chronic inflammatory disorders with common clinical, radiographic, and genetic features. Peripheral arthritis is the most common symptom of psoriatic arthritis and patients also frequently experience involvement of the entheses, spine, skin, and nails. Due to the diverse clinical spectrum of disease severity, tissues affected, and associated comorbidities, the treatment of psoriatic arthritis can be challenging and it is necessary to mitigate risks associated with both the disease and its treatment. These risks include disease-specific, treatment-related, and psychological risks. Disease-specific risks include those associated with disease progression that can limit functional status and be mitigated through early diagnosis and initiation of treatment. Risks also arise from comorbidities that are associated with psoriatic arthritis such as cardiovascular disease, obesity, diabetes mellitus, and gastrointestinal inflammation. Patient outcomes can be affected by the treatment strategy employed and the pharmacologic agents administered. Additionally, it is important for physicians to be aware of risks specific to each therapeutic option. The impact of psoriatic arthritis is not limited to the skin and joints and it is common for patients to experience quality-of-life impairment. Patients are also more likely to have depression, anxiety, and alcoholism. This article reviews the many risks associated with psoriatic arthritis and provides guidance on mitigating these risks.
银屑病关节炎是脊柱关节炎疾病家族的一部分，脊柱关节炎是一组具有共同临床、影像学和遗传特征的慢性炎症性疾病。外周关节炎是银屑病关节炎最常见的症状，患者还经常出现附着点、脊柱、皮肤和指甲受累。由于疾病严重程度、受累组织和相关合并症的临床谱各不相同，银屑病关节炎的治疗可能具有挑战性，因此有必要降低与疾病及其治疗相关的风险。这些风险包括疾病特异性风险、治疗相关风险和心理风险。疾病特异性风险包括与疾病进展相关的风险，这些风险可能会限制功能状态，可通过早期诊断和开始治疗来降低。风险也源于与银屑病关节炎相关的合并症，如心血管疾病、肥胖症、糖尿病和胃肠道炎症。患者的预后可能会受到所采用的治疗策略和所使用的药物的影响。此外，医生了解每种治疗选择的特定风险也很重要。银屑病关节炎的影响不仅限于皮肤和关节，患者出现生活质量受损很常见。患者也更有可能患有抑郁症、焦虑症和酗酒问题。本文综述了与银屑病关节炎相关的诸多风险，并提供了降低这些风险的指导。
