Mejjad O, Daragon A, Louvel J P, Da Silva L F, Thomine E, Lauret P, Le Loët X
Department of Rheumatology, Hôpital de Bois-Guillaume, CHU de Rouen, France.
Ann Rheum Dis. 1996 Mar;55(3):177-80. doi: 10.1136/ard.55.3.177.
To test the hypothesis that pustulosis palmaris et plantaris and psoriatic arthritis (PsA) are two distinct diseases, and that the associated dermatoses are therefore also distinct diseases.
We prospectively performed clinical, radiological, biological, and bone scan investigations in 23 outpatients with pustolotic arthritis and 23 outpatients with PsA, matched by gender, age (+/- one year) and duration of arthritis (+/- two years).
The anterior chest wall, especially the sternocostoclavicular joints, was more frequently involved in pustulotic arthritis than in PsA, both clinically (82% v 43%; p < 0.001) and radiologically (47% v 17%; p < 0.05). Sternocostoclavicular joints generally presented with erosive lesions in PsA, and with large ossifications in pustulotic arthritis. Peripheral joint involvement was mono- or oligoarticular, affecting proximal joints, in pustulotic arthritis (74% v 21%; p < 0.01), and polyarticular, involving small distal joints, in PsA (60% v 0%; p < 10(-4)), in which condition it was also more often erosive (43% v 8%; p < 0.01). The frequency of sacroiliitis and of spine involvement was similar in pustulotic arthritis and PsA. Biology and bone scan did not help distinguish between the two groups.
Pustulotic arthritis and PsA are clinically and radiologically different, therefore pustulosis palmaris et plantaris and psoriasis are most probably distinct dermatological diseases.
验证掌跖脓疱病和银屑病关节炎（PsA）是两种不同疾病这一假说，因此相关的皮肤病也是不同疾病。
我们前瞻性地对23例掌跖脓疱病关节炎门诊患者和23例PsA门诊患者进行了临床、放射学、生物学和骨扫描检查，两组在性别、年龄（±1岁）和关节炎病程（±2年）方面相匹配。
前胸壁，尤其是胸锁关节，在掌跖脓疱病关节炎中的临床受累率（82%对43%；p<0.001）和放射学受累率（47%对17%；p<0.05）均高于PsA。胸锁关节在PsA中通常表现为侵蚀性病变，而在掌跖脓疱病关节炎中表现为大的骨化。掌跖脓疱病关节炎的外周关节受累为单关节或寡关节，累及近端关节（74%对21%；p<0.01），而PsA的外周关节受累为多关节，累及远端小关节（60%对0%；p<10⁻⁴），且PsA中更常出现侵蚀性病变（43%对8%；p<0.01）。掌跖脓疱病关节炎和PsA中骶髂关节炎和脊柱受累的频率相似。生物学检查和骨扫描无助于区分这两组疾病。
掌跖脓疱病关节炎和PsA在临床和放射学上存在差异，因此掌跖脓疱病和银屑病很可能是不同的皮肤病。
