What Are the Different Types of Guttate Psoriasis Treatment?

Psoriatic arthritis is a serum-negative (ie, serum rheumatoid factor-negative) arthritis, which typically manifests as chronic, recurrent, benign papules, scaly skin lesions, fingernail damage, chronic , Recurrent, erosive polyarthritis around and / or vertebral joints and previous uveitis, conjunctivitis were the main lesions of the eye.

Psoriatic arthritis

Psoriatic arthritis is a serum-negative (ie, serum rheumatoid factor-negative) arthritis, which typically manifests as chronic, recurrent, benign papules, scaly skin lesions, fingernail damage, chronic , Recurrent, erosive polyarthritis around and / or vertebral joints and previous uveitis, conjunctivitis were the main lesions of the eye.

Chinese name

Psoriatic arthritis

Foreign name

Psoriatic arthritis

Cause

Unclear

First name

Changchun Huashan Dermatology Hospital

The cause is unclear. The cause of psoriatic arthritis is not fully understood. Found

The pathogenesis is not completely clear.

1. Immune factors The cause of psoriatic arthritis is unknown, but there are immunological manifestations, such as increased serum IgG, IgA, and IgE; anti-IgG antibodies (RF) are found in 45% of patients, so the disease may be considered an autoimmune disease. And found the serum

The diagnosis of psoriatic arthritis with uveitis is mainly based on typical skin lesions, nail lesions, peripheral arthritis (with or without sacroiliitis and spondylitis), and acute recurrent non-granulomatous anterior uve membrane Inflammation. Differential diagnosis:

Arthritis should be compared with other seronegative spondylitis (

Psoriasis

The spontaneous remission rate of psoriasis reaches 40%, but it is easy to relapse. Traditional Chinese medicine treatment has certain help in reducing symptoms and promoting resolution of skin lesions.

Treatment of anterior uveitis

Anterior uveitis mainly uses ciliary muscle paralysis agents,

The prognosis of systemic disease is usually good, but the prognosis is worse in patients with joint deformation. Long-term treatment with cytotoxic agents and other immunosuppressive drugs can cause serious side effects.

Psoriasis arthritis is more stubborn and the disease is prone to relapse. Good care can help patients alleviate some pain to a great extent. The nursing measures are as follows:

First: Change clothes in time according to the change of season, especially the protection of joints.

Second: In the winter, we must do a good job of cold protection and warmth of hands, feet and joints.

Third: Soak your hands and feet with hot water every night before going to bed to facilitate local blood circulation.

Fourth: Moderate physical exercise to enhance the flexibility of hands and feet.

The prevalence of psoriasis in the population is 1% to 3%. Psoriasis-associated arthritis occurs in about 5% to 7% of patients with psoriasis. The estimated prevalence rate is

Psoriatic arthritis skin lesions

A typical lesion of psoriasis is a skin plaque with clear edges, dark red, and "silver" scales (scales) on the periphery (Figure 1). Therefore, psoriasis joints

Psoriatic arthritis

Inflammation is also called "psoriasis". The amount of surface scales is related to the location of the lesion. On the extremities of the limbs (such as the elbows, knees, and sacrums), thick yellow and white scales often appear on the extremities. It's moist and less noticeable. The entire body can be affected, and the face is usually rare. This may be that sufficient ultraviolet rays in the environment can inhibit and prevent skin lesions. Skin pustules and erythema are also a common manifestation, and can occur locally or in large areas. In severe cases, fever, chills, burnout, and limb edema can occur.

About 15% to 30% of patients with psoriasis suffer from nail and toenail involvement. In patients with arthritis, fingernail (toe) nail involvement is up to 80%. Nail depression is a classic nail damage. Nail discoloration, cracking or loosening with or without deposition of keratin fragments under the nail is also common. (Figure 1), occasionally yellow-white vesicular lesions (oil droplet-shaped lesions) under the nail.

Psoriatic arthritis joint disease

Psoriasis-associated joint lesions can manifest as multiple types of arthritis. Some people divide them into the following 5 types.

(1) Asymmetric monoarthritis: This type accounts for 5% to 10%. It is mainly manifested as inflammation of the interphalangeal joints of the fingers and toes, showing diffuse finger (toe) swelling and a sausage-like appearance. Accompanied by damage to the nails.

(2) Chronic asymmetric oligoarthritis: This type accounts for 50% to 70%, and can affect 2 to 3 joints at the same time.

(3) Chronic symmetric polyarthritis: This type accounts for 15% to 25% of clinical manifestations similar to rheumatoid arthritis, but the serum rheumatoid factor is negative.

(4) Spinal arthritis: This type accounts for 20% to 30%. It is more common in male patients and is typically manifested as sacroiliitis, with or without spondylitis, and is closely related to HLA-B27 antigen.

(5) Disabling arthritis: This type accounts for about 5%. Arthritis manifests as continuous progress and leads to osteolysis, severe deformity and joint stiffness.

Among the above types of arthritis, disabling arthritis often causes significant pain, and the consequences are much more serious than the other four types. Compared with rheumatoid arthritis, except for disabling arthritis, its consequences are similar. The pain and consequences of the other four types are much lighter.

Psoriatic arthritis eye lesions

(1) Anterior uveitis: Anterior uveitis usually occurs in patients with arthritis and psoriasis, and patients with uveitis are generally older. Patients with sacroiliac joint involvement are prone to anterior uveitis, and patients with HLA-B27 antigen positive are also prone to anterior uveitis.

Uveitis associated with psoriatic arthritis can be manifested as acute recurrent non-granulomatous preuveitis, typically as ciliary congestion or mixed

Recurrent non-granulomatous pre uveitis

Syndrome hyperemia, dusty KP, generally have severe anterior chamber reactions, show significant anterior chamber flashes and a large number of anterior chamber inflammatory cells, and even anterior chamber pus and anterior chamber fibrous exudate (Figure 2) ; It can also be manifested as chronic non-granulomatous pre- uveitis, with occult onset, involvement of both eyes, and inflammation lasting longer than 6 months. The posterior segment of the eye is generally not affected, but in patients with chronic uveitis, the posterior segment of the eye may occasionally be affected, and secondary macular edema may also occur.

Because of this recurrent episode of anterior uveitis, post-iris adhesions, secondary glaucoma, and concurrent cataracts are prone to occur. In patients with secondary glaucoma, the visual prognosis is poor, so preventing post-iris adhesions is one of the most important aspects in the treatment of this uveitis.

(2) Eyelid and conjunctival lesions: Eyelids can appear similar to skin changes in other parts, simple erythema and swelling can occur, and chronic blepharitis, seborrheic dermatitis, and eyelash loss can occur.

Conjunctivitis is a common disease that occurs in about 20% of psoriatic arthritis with arthritis. It is manifested as non-specific inflammation, sometimes with catarrhal or purulent secretions, and eyelids, Granulomatous lesions of the bulbar conjunctiva. Conjunctival and eyelid lesions can cause complications such as eyelash loss, trichiasis, ectropion, blepharoplasty, and dry eyes.

(3) Scleritis: Approximately 2% and 1% of patients with psoriatic arthritis develop episcleritis and scleritis. These lesions occur many years after the disease occurs. In scleritis, prescleritis is more common. Type, but anterior necrotizing scleritis and posterior scleritis can also occur.

(4) Corneal lesions: The most common corneal lesions are superficial punctate keratitis. Superficial or deep corneal opacities, corneal neovascularization, corneal infiltration around the corneal ulcer, and limbal vesicular lesions may also occur.