CLINICAL MANIFESTATIONS OF PSORIATIC ARTHRITIS

Psorijatični artritis (PsA) oblik je upalnog artritisa koji može nastati u 30% bolesnika s kožnom psorijazom. Klinička slika može biti raznolika i prezentira se različitim zglobnim formulama. U osnovi, artritis može biti periferni i/ili aksijalni. Manifestira se kao simetrični poliartritis, asimetrični oligoartritis, artritis distalnih interfalangealnih (DIP) zglobova, destruktivni mutilirajući artritis ili kao spondiloartritis (SpA). Navedene zglobne formule mogu se preklapati ili se klinička slika može mijenjati tijekom liječenja. Od izvanzglobnih manifestacija javljaju se entezitisi i daktilitisi, psorijatične promjene na noktima, tjestasti edem šaka i stopala, promjene na očima te sindrom SAPHO (sinovitis, akne, palmoplantarna pustuloza, hiperostoza, osteitis). S obzirom na šaroliku kliničku sliku u idealnim uvjetima terapiju treba odabrati radi djelovanja na sve kliničke domene prisutne u kliničkoj slici bolesti.Psoriatic arthritis (PsA) is a form of infl ammatory arthritis that can occur in 30% of patients with psoriasis. Th e clinical picture can be varied and presented by diff erent joint aff ection formulas. Basically, arthritis can be peripheral and/or axial. It is manifested as symmetric polyarthritis, asymmetric oligoarthritis, arthritis of distal interphalangeal (DIP) joints, destructive mutilating arthritis, or spondyloarthritis (SpA). Th e above-mentioned joint aff ection formulas may overlap, or the clinical manifestations may change during treatment. Among extra-articular manifestations, there are enthesitis and dactylitis, psoriatic nail lesions, pitting edema, ocular involvement, and SAPHO syndrome (synovitis, acne, palmoplantar pustulosis, hyperostosis, osteitis). Considering the varying clinical picture, treatment should ideally always aim at improving all clinical domains that are present in the clinical picture of the disease