True about psoriatic ahritis are all expect ?
Ans. is 'c' i.e., More common in males Psoriatic ahritis does not have sex predilection. The largest and most consistent repoed relative risk has been with HLA-Cw6. Psoriatic ahritis involves DIP joints and the DOC for psoriatic ahritis is methotrexate. Psoriatic ahritis Psoriatic ahritis refers to an inflammatory ahritis that characteristically occurs in individuals with psoriasis. Only 5% of patients with psoriasis develop ahritis. In 60-70% of cases, psoriasis precedes joint disease. In 15-20%, the two manifestations appear within 1 year of each other. In about 15-20% of cases, the ahritis precedes the onset of psoriasis and can present a diagnostic challange. Clinical features The usual age at onset is 30-50 years. The patient may present with one of several patterns of joint involvement. These include : Ahritis of distal interphalangeal (DIP) joints Assymetrical oligoahritis : Most common pattern Symmetrical polyahritis similar to RA Axial involvement (sacroiliac and spine) similar to ankylosing spondylitis Ahritis multilans So, Psoriatic ahritis can present with symptoms similar to any other inflammatory ahritis (RA, AS) or with any other different pattern. Shoening of digitis, called telescoping, because of underlying osteolysis is paicularly characteristic of Psoriatic ahritis and there is much greater tendency than in RA for both fibrous and bony ankylosis. Other findings are enthesitis, nail changes, and tenosynovitis. Treatment of Psoriatic ahritis Anti TNF - a agents eg etanercept and infliximab are newer drugs and are effective even in longstanding restistent PsA cases to previous therapy and extensive skin lesion. Methotrexate is drug of choice. Other effective agents are sulfasalazine, cyclosporine, retinoic acid & psoralen & UV-A (PUV A). Use of immunosuppressive therapy including anti TNF a agents, methotrexate and cycloserine are contraindi cated in HIV associated PsA.
HLA-Cw6 association
Involvement of DIP joint
More common in males
DOC is methotrexate