PSORIATIC ARTHRITIS

Question 1

major areas affected?

Answer 1

abdomen

neck, behind ears

Question 2

how many have it, what percent is diagnosed?

Answer 2

7 million adults

only 7.4 have diagnosis, 520,000 people

Question 3

what are the immune responses?

Answer 3

innate and adaptive immune responses

look for inflammatory cytokines, TNF (IL-17) leading to enthesitis and dactylitis (indicates severity)

gut inflammation and IBD suggest microbiome involvement

Question 4

common medical illnesses?

Answer 4

HTN, obesity, heart disease, depression, alcoholism

Question 5

hallmark of PSA?

Answer 5

dactylitis of 3rd MTP

Ddx

• PSA
• syphillis
• sarcoidosis
• crystal (gout and pseudo gout)
• septic

Question 6

main domains of psoriasis?

Answer 6

peripheral arthritis 
dactylitis
enthesitis
skin
nails
axial disease

Question 7

major meds for PSA?

Answer 7

TNF inhibitors

IL-17 antagonists

IL-12/23 antagonists

PDE-4 inhibitor

JAK inhibitor

T cell inhibitor

Question 8

role of podiatry

Answer 8

1/3 patients have PSA

foot and ankle initial symptoms: synovitis, dactylitis, achilles tendonitis, subtler, retrocalcaneal

imaging and labs helpful

refer to rheumatology