Sanford Zachary, Webb Ralph W
Rheumatology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Cureus. 2020 Sep 15;12(9):e10470. doi: 10.7759/cureus.10470.
The authors present a case of monoarticular psoriatic arthritis affecting the knee of a woman with no previously identified manifestations of psoriasis. At time of symptom onset, joint aspirates were initially sterile with predominantly neutrophilic leukocytosis; however, repeat aspiration and culture was positive for Candida parapsilosis. Despite appropriate antifungal treatment, symptoms continued to worsen and other large joint manifestations including the contralateral elbow raised suspicions for alternative etiology. Ultimately new onset skin excoriations on the palms suggested psoriatic arthritis, which was subsequently treated with immunosuppressive therapy.
作者报告了一例单关节银屑病关节炎病例，累及一名此前未发现银屑病表现的女性的膝关节。症状出现时，关节穿刺液最初无菌，主要为中性粒细胞增多；然而，重复穿刺和培养发现近平滑念珠菌呈阳性。尽管进行了适当的抗真菌治疗，症状仍持续恶化，包括对侧肘部在内的其他大关节表现引发了对其他病因的怀疑。最终，手掌上新出现的皮肤破损提示为银屑病关节炎，随后接受了免疫抑制治疗。
