Dinu Alina, Bucur Stefana, Olteanu Rodica, Constantin Traian, Raducan Anca, Baetu Mara, Constantin Maria-Magdalena
Second Department of Dermatology, Colentina Clinical Hospital, 20125 Bucharest, Romania.
Department of Urology, 'Th. Burghele' Hospital, 50652 Bucharest, Romania.
Exp Ther Med. 2020 Jul;20(1):47-51. doi: 10.3892/etm.2019.8322. Epub 2019 Dec 12.
Considering that most of the patients (>2/3) are diagnosed with psoriasis in the cutaneous form long before the joint damage occurs and, in these conditions, a significant proportion of them is found in the dermatologist's initial records, a question must be asked: when is it necessary to send these patients to a rheumatology consultation? The recognition of psoriatic arthritis in patients with vulgar psoriasis and the dermatologist's ability to differentiate it from other arthritis, offers the opportunity to improve patient prognosis by prompt intervention and close collaboration with the rheumatologist. Diagnosis of early psoriatic arthropathy should be considered when a patient with psoriasis or family history of psoriasis has peripheral inflammatory arthritis (oligoarthritis or distal interphalangeal joints damage), enthesitis, dactylitis, spinal pain of inflammatory type. Given that patients with psoriasis are included in the dermatologists' medical records, it is very important to recognize psoriatic arthritis in patients with cutaneous psoriasis, to differentiate it from other possible arthritis, thus having the possibility to improve patient prognosis by prompt intervention and through collaboration with the rheumatologist.
鉴于大多数患者(超过2/3)在关节损伤发生之前很久就被诊断为皮肤型银屑病,而且在这种情况下,很大一部分患者在皮肤科医生的初始记录中就已被发现,因此必须提出一个问题:何时有必要将这些患者送去进行风湿病会诊?识别寻常型银屑病患者中的银屑病关节炎以及皮肤科医生将其与其他关节炎区分开来的能力,为通过及时干预以及与风湿病医生密切合作来改善患者预后提供了机会。当患有银屑病或有银屑病家族史的患者出现外周炎性关节炎(少关节炎或远端指间关节损伤)、附着点炎、指(趾)炎、炎性脊柱疼痛时,应考虑早期银屑病关节炎的诊断。鉴于银屑病患者包含在皮肤科医生的病历中,识别皮肤型银屑病患者中的银屑病关节炎并将其与其他可能的关节炎区分开来非常重要,这样就有可能通过及时干预并与风湿病医生合作来改善患者预后。