Management of psoriatic arthritis: The therapeutic interface between rheumatology and dermatology

Abstract

Psoriatic arthritis is an inflammatory arthritis, which occurs in up to 30% of individuals with psoriasis. Dermatologists and other physicians treating psoriasis are in an ideal position to screen for the condition, and with rheumatologists, strategize optimal therapy. Mild skin and joint manifestations may be treated effectively with topical agents, ultraviolet light therapy, and nonsteroidal anti-inflammatory drugs. More severe manifestations of the disease, including progressive peripheral joint damage, spine disease, enthesitis, dactylitis, and severe skin changes, require systemic therapy. Traditional systemic agents include methotrexate, sulfasalazine, and cyclosporine. When these agents are not adequate or not tolerated, new biologic agents, particularly anti-tumor necrosis factor (TNF) compounds, have shown significant and enduring benefit in all disease domains, improvement in quality of life and function, and inhibition of progressive joint damage.

The PASE questionnaire: Pilot-testing a Psoriatic Arthritis Screening and Evaluation tool

“…2 A close working relationship between the dermatology and rheumatology departments may help facilitate the diagnosis and provide the most favorable treatment option for the patient. [3][4][5] The approach to the management of psoriasis and PsA has significantly changed within the last few years. 6 The advent of biologic therapy and the impact these drugs have on inflammatory joint disease have made it important for physicians to identify PsA early.…”

Cyclosporin a (Sandimmun Neoral) in Therapy for Psoriasis and Psoriatic Arthritis

“…При неэффективности или непереносимости этих БПВП назначают генно-инженерные биологические препараты -ингибиторы ФНО α, -которые положительно влияют на все проявления ПсА, улучшают качество жизни и функ-циональную способность больных, подавляют прогресси-рование поражения суставов [7]. Одним из иммуноактивных средств в терапии псориаза и ПсА является ЦсА, который был выделен в 1969 г. из ми-целия двух видов грибов (Cilindocarpum lucidum и Tolypocladium inflatum).…”

Psoriatic Arthritis: Pharmacotherapy Update

“…Current estimates are that about 20% to 30% of patients with psoriasis will develop PsA (range of prevalence estimates, 6%-39% [1]). There is still no clearcut genetic or other laboratory or clinical biomarker that will alert us as to which psoriasis patients will develop PsA.…”

“…It is not known if current use of more effective biologic agents for psoriasis will delay or prevent the appearance of PsA. A key element in recognition and proper management of PsA is the quality of the dermatologist-rheumatologist interaction in the comanagement of the patient with PsA [1].…”