This is a seronegative inflammatory arthritis
It is found in patterns with psoriasis, a past or family history of psoriasis, or with characteristic changes in the nails (nail pitting).
Sometimes there is a single patch of psoriasis typically hidden in the scalp, gluteal cleft or
• Arthritis develops in about 7% of patients with psoriasis.
The onset is usually between the age of 25-40 years.
Arthritis involves distal interphalangeal joints usually associated with nail changes.
• Skin lesions: scaling lesions typically over extensor surfaces.
• Nail changes: pitting, onycholysis, and horizontal ridging.
• RA factor and ANA are negative.
• ESR is moderately raised.
• X-ray shows asymmetrical disease involving distal interphalangeal joints. There is relatively little periarticular osteopenia (that is common in RA).
. Methotrexate may be used
• Splints and prolonged rest are avoided because of the increased tendency to fibrous and bony ankylosis.
• Intra-articular injections may be used in persistently active and symptomatic joints.