Seszták M, Koó E, Farkas V, Weisz M
Országos Reumatológiai és Fizioterápiás Intézet, L. Reuma Osztály, Budapest.
Orv Hetil. 1995 Apr 16;136(16):811-6.
The interval between the appearance of the symptoms of psoriasis and/or arthritis and the setting up the diagnosis of the psoriatic arthritis was studied in 215 patients suffering from definite psoriatic arthritis. About 2.3 years were over until the setting-up of the diagnosis in these 30 patients whose psoriasis and arthritis began simultaneously. The interval to set up the diagnosis of psoriatic arthritis was 5.4 years in average if the psoriasis itself was the first sign and it was 8.6 years in case the arthritis preceded psoriasis. The symptoms promoting to set up the right diagnosis were in order to frequency as follows: appearance of psoriasis, sausage digits, distal interphalangeal involvements, nail changes and transformation the monoarthritis into asymmetrical oligoarticular or polyarticular form. The difficulty of the differential diagnosis was studied. 15 different previous false diagnoses were enumerated the rate of which was the highest (67.3%) in the group starting with arthritis. The authors call the attention to the importance of looking for psoriatic skin and nail changes in every nonclassified arthritic patient in the interest of an early diagnosis and right therapy in course of the follow-up.
对215例确诊为银屑病关节炎的患者，研究了银屑病和/或关节炎症状出现至确立银屑病关节炎诊断之间的间隔时间。在这30例银屑病和关节炎同时起病的患者中，直至确立诊断平均过去了约2.3年。如果银屑病本身是首发症状，确立银屑病关节炎诊断的间隔时间平均为5.4年；如果关节炎先于银屑病出现，则为8.6年。促使确立正确诊断的症状按出现频率依次为：银屑病出现、腊肠指、远端指间关节受累、指甲改变以及单关节炎转变为不对称少关节或多关节形式。研究了鉴别诊断的困难之处。列举了15种不同的既往误诊情况，其中以关节炎起病的组误诊率最高（67.3%）。作者提醒注意，为了早期诊断并在随访过程中进行正确治疗，对每一位未分类的关节炎患者都要注意检查有无银屑病皮肤和指甲改变。
