Conceitos atuais e relevantes sobre artrite psoriásica

Abstract

Psoriatic arthritis (PsA) is a systemic, polymorphic joint disease with variable presentation and clinical course. The outcome depends on the association with severe comorbidities such as diabetes, hypertension and dyslipidemia. Early diagnosis requires a high degree of clinical suspicion, especially when skin manifestations are subtle and poorly defi ned. Progressive erosive disease can occur in up to half of patients, associated with anatomical and functional changes in about 20%. Thus, the prognosis of PsA remains unclear, especially if diagnosis and treatment are delayed. Based on extensive literature review (PubMed and Lilacs) and experience of our services, new concepts of immunogenetics, pathophysiology, and clinical and therapeutic aspects are discussed. Factors that reduce the quality of life and life expectancy of patients, as well as new guidelines for treatment, will be emphasized. Control of infl ammation, especially in enthesitis and axial forms of PsA, was made possible due to the introduction of anti-TNF biologics. Finally, the role of GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) should be emphasized, since it promotes meetings and joint studies between rheumatologists and dermatologists to provide scientifi c evidence for the sweeping changes in clinical management and treatment of patients with PsA.

Semantic and psychometric validation of the Brazilian Portuguese version (PASE-P) of the Psoriatic Arthritis Screening and Evaluation questionnaire

“…Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis (Pso) [ 1 , 2 ], with reported prevalence varying from 6 to 42% and values of 30% in a Brazilian population [ 2 – 4 ]. PsA is difficult to diagnose in its early stages; however, it can progress, causing anatomical damage that impairs the functional capacity of patients [ 3 , 5 , 6 ].…”

Psoriasis, Psoriatic Arthritis, and Thyroid Autoimmunity

“…Psoriatic arthritis (PsA) is a chronic inflammatory arthritis that has a variable clinical presentation and occurs approximately in 30% of PsO patients (7, 9, 10). PsA typically affects the joints of the fingers and toes, and it is characterized by a painful inflammation of the joints and surrounding connective tissue.…”

“…PsA can also affect the hips, spine (spondylitis), knees, and sacroiliac joint (sacroiliitis), and any other joint (11). Dermatologic manifestations of PsO appear before the manifestations of arthritis in about 75% of patients (10). …”

Tradução, adaptação transcultural e validação do instrumento psoriatic arthritis screening and evaluation (pase) para a língua portuguesa brasileira

“…A artrite psoriásica é uma doença inflamatória que acomete a pele e o sistema musculoesquelético (TAYLOR et al, 2006;FAVARATO;RANZA, 2012). Neste último, manifesta-se nas articulações e nas inserções dos tendões (enteses), com curso geralmente insidioso e progressivo (GARG; GLADMAN, 2010;RANZA, 2013).…”

“…É importante frisar que cerca de 80% dos pacientes com doença articular tem envolvimento ungueal, por vezes sutil. Portanto, pacientes com suspeita clínica de APs devem ser cuidadosamente examinados a procura de sinais de psoríase oculta, não apenas em couro cabeludo, regiões periumbilical, glútea e perianal, mas, sobretudo, nas unhas FAVARATO;RANZA, 2012;RANZA et al, 2013;SAAD;GONÇALVES, 2010;GONÇALVES, 2007;GLADMAN et al, 2005 Tabela -Prevalência de APs de acordo com a extensão da psoríase medida pela palma das mãos Extensão da psoríase Prevalência de APs < 1 palma mão 6%…”