Psoriatic arthritis

Psoriatic arthritis is a chronic inflammatory arthritis associated with -psoriasis. Psoriatic arthritis belongs to the group of seronegative spondyloarthropathies and may present with both peripheral joint and axial skeleton involvement. In addition to joint and cutaneous disease, the other common features of psoriatic arthritis include dactylitis and enthesitis, resulting from involvement of surrounding tendons and ligaments as well as nail changes including pitting, ridging, and distal onycholysis. Familial aggregation of cases is common with HLA-B27 positivity reported in 10-25% of patients. There are no validated diagnostic criteria available for psoriatic arthritis and diagnosis should be based on the presence of characteristic clinical manifestations, physical examination, laboratory and imaging findings, and additionally, by the process of elimination of other common inflammatory -Arthritides. The treatment of patients presenting with more severe joint disease, unresponsive to nonsteroidal anti-inflammatory drugs (NSAIDs), extra-Articular manifestations and/or poor prognostic factors require use of systemic disease-modifying anti-rheumatic drugs (DMARDs) and/or biologic agents. Cases related to the presentation of the spectrum of psoriatic arthritis are discussed.