Analysis Of Clinical Data In28Patients With Psoriatic Arthritis

Objective: Psoriatic arthritis, also named as psoriasis arfhropathica, it isdefined as an inflammatory arthritis associated with psoriasis, with skin leionsof psoriasis, the joint and surrounding soft tissue pain, swelling, tenderness,stiffness and movement disorders, some patients with sacroiliitis and/orspondylitis, defer of course of diseases, easy to relapse, later period jointankylosis, leading to disability. Therefore, the correct diagnosis, reasonabletreatment and scientific evaluation of the efficacy, for dermatologists andrheumatologists are big challenges. Because of the clinical characteristics ofthe disease the patient can visit dermatologists and or rheumatologists, thedoctors who work in the two departments must face the challenges. In order tomake this disease can get the complete guide to reference information in thediagnosis, treatment and curative effect evaluation system, we will review therecent five years the actual clinical work. In this study the psoriatic arthritishospitalized patients in department of dermatology and/or rheumatology inthe Second Hospital of Hebei Medical University were reviewed fromJanuary1st,2006to July1st,2011. We retrospectively analyzed the Psoriaticarthritis patients' diagnosis, treatment and curative effect evaluation system.Our study was to get preliminary understanding of the diagnosis, treatmentand curative effect evaluation system, and to provide the guidance informationin the area of these for the doctors of the two departments.Methods:28cases in the department of dermatology and rheumatologyof The Second Hospital of Hebei Medical University from January1st,2006to July1st,2011were reviewed. The points focused on the clinical features,diagnosis, treatment and curative effect evaluation system of psoriatic arthritis.Results:1Among the28patients, the average age of onset was37.2years old,and the ratio of male to female was1.55:1. The skin lesions manifested prior to arthritis in20cases(76.92%), arthritis prior to skin lesions occurredonly in3cases(11.53%), and both symptoms of skin and joints appearedsimultaneously in3cases(11.53%).2According to diagnostic criteria of Moll＆Wright, as for the types ofarthritis,13cases (46.42%) were asymmetrical arthritis of major joints,3cases(10.71%) symmetrical arthritis of multiple joints4cases (14.28%) mutilationpatterns,5cases (17.85%) distal interphalangeal arthritis, and3cases (10.71%)spondyloarthropathy. The clinical classification is mainly asymmetricalarthritis of major joints, and in our study13cases (46.42%) were asymmetricalarthritis of major joints, at least5joints involved. Any type of psoriasis canappear joints disease. And arthritis of distal interphalangeal arthritis was themost commonly seen (53.57%), followed by knee (39.28%) and ankle(39.28%).318patients received X-ray examination, of which16casesrevesled jointdamages. The common radiological findings were articular soft tissue swelling,blurred articular surface, narrowing of joint space, osteoporosis, visible cysticlow density, worm-eaten shaped bone defects, including4patients with handjoint fusion deformity,occurred in the distal interphalangeal arthritis.1patienthad toes joint fusion.1patient had narrowed of lumbar vertebra space of1patient, antisternum appeared bamboo like change.4Many treatments of28patients.8patients were reviewed for using ofbiological products, biological products relieved joint symptoms after threedays of treatment, improved psoriatic lesions after8days;7patients weretreated with methotrexate, nonsteroidal anti-inflammatory drugs leflunomideand sulfasalazine, the times of joint symptoms and lesions to relieve after thistreatment are seven and ten days;3patients were treated with Cyclosporin Aand NSAIDs, the times of the joints and lesions to reduce after this treatmentare2.5days.Conclusion:1PsA is a cross sections disease. It is urgent to get the complete guide toreference information in the diagnosis, treatment and curative effect evaluation system, especially in effect evaluation system of psoriatic arthritis.2NSAISDs and traditional DMARDS are usually used in the treatmentof PsA, in the clinical several drug combination are used. Mild moderateoligoarthritis of patients can be treated with NSAIDs, and patients with activelesions and joint symptoms can be treated with NSAIDs and DMARDScombination.3Methotrexate is most commonly used in treatment of PsA in DMARDS,on psoriatic skin lesions and arthritis symptoms has better effect. Low doses ofMTX and other DMARDS used in combination have good results in themanagement of PsA, and the side effects of increase is not significant.4Biological products work fast, inhibit radiographic progression, arehighly specific and safety, are well tolerated in patients with PsA, easy to use,have high cost of a long-term appliciation. According to the patient's illnesscan be in heavy use of biological products to control the illness, the diseasecontrol after reduced its dosage and added traditional drugs, in order toachieve long-term relief illness, maintain stable condition.