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Psoriatic arthritis

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439: 467: 498: 529: 438: 319: 350: 53: 466: 497: 580:), involves a greater number of joints than psoriatic arthritis, and affect them symmetrically. Involvement of the spinal joints is more suggestive of psoriatic arthritis than rheumatoid arthritis. Osteoarthritis shares certain clinical features with psoriatic arthritis such as its tendency to affect multiple distal joints in an asymmetric pattern. Unlike psoriatic arthritis, osteoarthritis does not typically involve 528: 969:
Psoriatic arthritis can develop in people who have any level severity of psoriatic skin disease, ranging from mild to very severe. Studies have found that obesity is a significant risk factor and predictor of disease outcome. Other risk factors associated with an increase risk of developing psoriatic
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are used in persistent symptomatic cases without exacerbation. Rather than just reducing pain and inflammation, this class of drugs helps slow down or halt the progression of the disease, and to therefore limit the amount of joint damage that occurs. Most DMARDs act slowly and may take weeks or even
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is seen at the tendon insertion (short thin arrow). (b, c) T1 weighted images of a different section of the same patient, before (panel b) and after (panel c) intravenous contrast injection, confirm inflammation (large arrow) at the enthesis and reveal bone erosion at tendon insertion (short thin
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Along with the above-noted pain and inflammation, there is extreme exhaustion that does not go away with adequate rest. The exhaustion may last for days or weeks without abatement. Psoriatic arthritis may remain mild or may progress to more destructive joint disease. Periods of active disease, or
2052: 1445: 337:(inflammation of the synovial membrane; large arrows). There is joint space narrowing with bone proliferation at the third proximal interphalangeal joint and erosions are present at the fourth distal interphalangeal joint (white circle). Extracapsular enhancement (small arrows) is seen 277:
genes. Thematically, these genes are often those that identify human tissues as normal and healthy, or the genes in immune cells designed to recognize those identifiers. If the genes are functioning abnormally, then the immune system has a higher risk of attacking normal tissues.
176:, and the wrist. Involvement of the distal interphalangeal joints is a characteristic feature present in many cases. Nail pitting often accompanies distal interphalangeal joint involvement and may be essential in differentiating psoriatic arthritis from other diseases. 237:
disease, with many genes known or theorized to contribute to its clinical presentation (or lack thereof). When someone with the genes for psoriatic arthritis comes into contact with certain substances, these substances may induce an autoimmune reaction, causing the
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technology. Biologic medications are derived from living cells cultured in a laboratory. Unlike traditional DMARDS that affect the entire immune system, biologics target specific parts of the immune system. They are given by injection or intravenous (IV) infusion.
614:): Affects less than 5% of patients and is a severe, deforming and destructive arthritis. This condition can progress over months or years causing severe joint damage. Arthritis mutilans has also been called chronic absorptive arthritis, and may be seen in 538:. Shown are T1-weighted semi-coronal magnetic resonance images through the sacroiliac joints (a) before and (b) after intravenous contrast injection. Enhancement is seen at the right sacroiliac joint (arrow, left side of the image), indicating active 168:, defined as inflammation affecting two to four joints during the first six months of disease, is present in 70% of cases. However, in 15% of cases, the arthritis is symmetrical. The joints of the hand that is involved in psoriasis are the 980:
More than 80% of patients with psoriatic arthritis will have psoriatic nail lesions characterized by nail pitting, separation of the nail from the underlying nail bed, ridging and cracking, or more extremely, loss of the nail itself
768:, are associated with a statistically significant 50 to 66% relative risk reduction in gastrointestinal ulcers and bleeding complications compared to traditional NSAIDs, but carry an increased rate of cardiovascular events such as 977:. For the majority of people, this is between the ages of 30 and 55, but the disease can also affect children. The onset of psoriatic arthritis symptoms before symptoms of skin psoriasis is more common in children than adults. 242:
to target normal tissues in the body. The exact strength, location, and clinical effects of this reaction depend on which genes are involved for each individual. The substance that triggers the reaction is typically not known.
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It is given in tablet form and taken by mouth. Side effects include headaches, back pain, nausea, diarrhea, fatigue, nasopharyngitis and upper respiratory tract infections, as well as depression and weight loss.
3072: 3049: 636:): This type of psoriatic arthritis is found in about 5% of patients, and is characterized by inflammation and stiffness in the joints nearest to the ends of the fingers and toes. Nail changes are often marked. 163:
Pain, swelling, or stiffness in one or more joints is commonly present in psoriatic arthritis. Psoriatic arthritis is inflammatory, and affected joints are generally red or warm to the touch. Asymmetrical
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Oligoarticular: This type affects around 70% of patients and is generally mild. This type does not occur in the same joints on both sides of the body and usually only involves fewer than 3 joints.
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under the nails, and horizontal ridging. Psoriasis classically presents with scaly skin lesions, which are most commonly seen over extensor surfaces such as the scalp, natal cleft and umbilicus.
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In addition to affecting the joints of the hands and wrists, psoriatic arthritis may affect the fingers, nails, and skin. Sausage-like swelling in the fingers or toes, known as
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Biologics may increase the risk of minor and serious infections. More rarely, they may be associated with nervous system disorders, blood disorders or certain types of cancer.
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are theorized to be involved in patients with psoriatic arthritis, in contrast to most people with psoriasis whose bone cells are not significantly involved in the disease.
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Psoriatic arthritis affects up to 30% of people with psoriasis and occurs in both children and adults. Approximately 40–50% of individuals with psoriatic arthritis have the
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plaques) frequently occur before the onset of psoriatic arthritis but psoriatic arthritis can precede the rash in 15% of affected individuals. It is classified as a type of
1746:"Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials" 1486:
Singh JA, Guyatt G, Ogdie A, Gladman DD, Deal C, Deodhar A, Dubreuil M, Dunham J, Husni ME, Kenny S, Kwan-Morley J, Lin J, Marchetta P, Mease PJ, Merola JF (Jan 2019).
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Polyarticular: This type accounts for around 25% of cases, and affects five or more joints on both sides of the body simultaneously. This type is most similar to
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on the skin, 15 percent develop skin psoriasis and arthritis at the same time, and 15 percent develop skin psoriasis following the onset of psoriatic arthritis.
2630: 456:(long thin arrow). There is synovitis at the proximal interphalangeal joint (long thick arrow) plus increased signal in the overlying soft tissues indicating 460:(short thick arrow). There is also diffuse bone edema (short thin arrows) involving the head of the proximal phalanx and extending distally down the shaft. 356:
magnetic resonance images of the ankle region in psoriatic arthritis. (a) Short tau inversion recovery (STIR) image, showing high signal intensity at the
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Gottlieb A, Korman NJ, Gordon KB, Feldman SR, Lebwohl M, Koo JY, Van Voorhees AS, Elmets CA, Leonardi CL, Beutner KR, Bhushan R, Menter A (May 2008).
1353:"Benefit of early treatment in inflammatory polyarthritis patients with anti-cyclic citrullinated peptide antibodies versus those without antibodies" 1974: 2715: 2738: 2443: 373:
There is no definitive test to diagnose psoriatic arthritis. Symptoms of psoriatic arthritis may closely resemble other diseases, including
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months to take full effect. According to a recent Cochrane review, low dose oral methotrexate was slightly more effective than placebos.
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Because prolonged inflammation can lead to joint damage, early diagnosis and treatment to slow or prevent joint damage is recommended.
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arthritis include severe psoriasis, nail psoriasis, scalp psoriasis, inverse psoriasis, and having a first-degree relative with PsA.
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drugs can also reduce psoriasis skin symptoms but can lead to liver and kidney problems and an increased risk of serious infection.
2690: 1705:"Use of nonsteroidal antiinflammatory drugs: an update for clinicians: a scientific statement from the American Heart Association" 2297: 576:-associated arthritis. In contrast to psoriatic arthritis, rheumatoid arthritis tends to affect the proximal joints (e.g., the 1585: 1276: 1098: 1065: 399: 954:. Surgery is effective for pain alleviation, correcting joint disfigurement, and reinforcing joint usefulness and strength. 776:. Both COX-2 inhibitors and other non-selective NSAIDS have potential adverse effects that include damage to the kidneys. 1488:"2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis" 2642: 2290: 1441: 1338: 2048: 2882: 2356: 2272: 756:. NSAIDs can irritate the stomach and intestine, and long-term use can lead to gastrointestinal bleeding. Coxibs ( 2447: 903:
recently demonstrated a 20% improvement in signs and symptoms of disease at week 12 as compared to placebo in a
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flares, will typically alternate with periods of remission. In severe forms, psoriatic arthritis may progress to
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at the third and fourth proximal interphalangeal and distal interphalangeal joints is seen, indicating active
2949: 2096: 893: 826: 666: 183:, may occur. Psoriasis can also cause changes to the nails, such as pitting or separation from the nail bed, 3165: 2680: 2466: 2371: 569: 473: 2915: 1999:
Brosseau L, Robinson V, Wells G, Debie R, Gam A, Harman K, Morin M, Shea B, Tugwell P (19 October 2005).
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in psoriatic arthritis. Signs of active inflammation are seen at several levels (arrows). In particular,
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in cases where one joint is severely affected. In psoriatic arthritis patients with severe joint damage
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of the fingers in psoriatic arthritis. Shown are T1-weighted (a) pre-contrast and (b) post-contrast
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of the spine, but can also affect the hands and feet, in a similar fashion to symmetric arthritis.
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Other symptoms that are more typical of psoriatic arthritis than other forms of arthritis include
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Scholer DW, Ku EC, Boettcher I, Schweizer A (April 1986). "Pharmacology of diclofenac sodium".
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in the Achilles tendon (inflammation of the Achilles tendon where it inserts into the bone) or
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and concluded that it could be considered for relief of pain and stiffness associated RA.
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Health and environmental factors known to be associated with psoriatic arthritis include:
8: 3076: 3013: 2966: 2853: 2462: 1083: 503:(a) T1-weighted and (b) short tau inversion recovery (STIR) magnetic resonance images of 124: 96:
with a sausage-like appearance ("sausage digit"). This often happens in association with
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Several conditions can mimic the clinical presentation of psoriatic arthritis including
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Magnetic resonance images of the fingers in psoriatic arthritis. Shown are T1 weighted
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The Johns Hopkins University School of Medicine and the Johns Hopkins Arthritis Center
1922:"Tofacitinib for psoriatic arthritis (PsA) is now approved by the European Commission" 1721: 1704: 1446:
The Johns Hopkins University School of Medicine and the Johns Hopkins Arthritis Center
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approved for use by the FDA in 2014. By inhibiting PDE4, an enzyme which breaks down
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Factors that contribute to a diagnosis of psoriatic arthritis include the following:
365: 349: 330: 270: 211: 65: 3127: 2245: 2154: 1248: 1188: 1022:, psoriatic arthritis is more common among Caucasians than African or Asian people. 364:, thick arrow) and in the synovium of the ankle joint (synovitis, long thin arrow). 2838: 2830: 2705: 2700: 2496: 2412: 2225: 2126: 2114: 2020: 2016: 2012: 2001:"Low level laser therapy (Classes I, II and III) for treating rheumatoid arthritis" 1933: 1893: 1881: 1877: 1832: 1814: 1806: 1765: 1757: 1716: 1677: 1640: 1630: 1573: 1515: 1499: 1413: 1372: 1364: 1226: 1168: 888:(Sotyktu), which has been approved for plaque psoriasis, is currently undergoing a 757: 626: 535: 511: 452:
image. Focal increased signal (probable erosion) is seen at the base of the middle
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Severe psoriatic arthritis of both feet and ankles. Note the changes to the nails.
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Psoriasis in the patient, or a family history of psoriasis or psoriatic arthritis.
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Antman EM, Bennett JS, Daugherty A, Furberg C, Roberts H, Taubert KA (Mar 2007).
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has identified several genes involved in some patients, notably genes related to
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clinical trial to evaluate the efficacy and safety on psoriatic arthritis. The
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are thought to be strongly involved in the development of psoriatic arthritis.
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Seventy percent of people who develop psoriatic arthritis first show signs of
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in psoriatic arthritis (mutilans form). Shown is a T2 weighted fat suppressed
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Kearney PM, Baigent C, Godwin J, Halls H, Emberson JR, Patrono C (Jun 2006).
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to the third and fourth proximal interphalangeal joints, indicating probable
326: 239: 3062: 1635: 1402:"Guidelines of care for the management of psoriasis and psoriatic arthritis" 973:
Psoriatic arthritis tends to appear about 10 years after the first signs of
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List of human leukocyte antigen alleles associated with cutaneous conditions
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may be implemented to correct joint destruction, usually with the use of a
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Guidelines of care for the management of psoriasis and psoriatic arthritis
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Warner TD, Giuliano F, Vojnovic I, Bukasa A, Mitchell JA, Vane JR (1999).
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Ritchlin CT, Colbert RA, Gladman DD (2017-03-08). "Psoriatic Arthritis".
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Farragher TM, Lunt M, Plant D, Bunn DK, Barton A, Symmons DP (May 2010).
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Ritchlin CT, Colbert RA, Gladman DD (March 2017). "Psoriatic Arthritis".
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US National Institute of Arthritis and Musculoskeletal and Skin Diseases
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Typically the medications first prescribed for psoriatic arthritis are
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is observed in 30 to 50% of patients and most commonly involves the
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Arthritis psoriatica, arthropathic psoriasis, psoriatic arthropathy
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and certain forms of psoriasis are thought to increase the risk.
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Isaacs D (2013). "Infectious Risks Associated with Biologics".
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clinical trial to evaluate the efficacy and safety of TAK-279.
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treatment option for the management of psoriatic arthritis is
625:): This type is characterized by stiffness of the neck or the 409:), which is associated with psoriasis and psoriatic arthritis. 303:
Tissue trauma, or deep lesions associated with sites of trauma
1702: 1544:"Secukinumab Has Superior Persistence in Psoriatic Arthritis" 1212: 733: 457: 1608: 780:
Conventional synthetic disease-modifying antirheumatic drugs
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at the second finger with enhancement and thickening of the
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Men and women are equally affected by this condition. Like
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Radiologic images demonstrating degenerative joint changes.
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Amherd-Hoekstra A, Näher H, Lorenz HM, Enk AH (May 2010).
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In psoriatic arthritis, pain can occur in the area of the
2923: 1743: 1060:(6th ed.). New York: McGraw-Hill. pp. 427–436. 476:(a) pre-contrast and (b) post-contrast images exhibiting 2112: 2113:
Scher JU, Ogdie A, Merola JF, Ritchlin C (March 2019).
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spondylitis is seen at level L1/L2 and an inflammatory
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James, William, Berger, Timothy, Elston, Dirk (2005).
395:, a blood factor associated with rheumatoid arthritis. 21:"PsA" redirects here. For the star constellation, see 198:(the lower back, above the tailbone), as a result of 3031: 1056:
Freedberg, Irwin M., Fitzpatrick, Thomas B. (2003).
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Hot Topics in Infection and Immunity in Children IX
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Andrews' Diseases of the Skin: Clinical Dermatology
222:which on X-ray gives a "pencil-in-cup" appearance. 596:There are five main types of psoriatic arthritis: 1792: 1333:, Churchill Livingstone/Elsevier, p. 1096, 2010. 812: 677:Biologics prescribed for psoriatic arthritis are 645:The underlying process in psoriatic arthritis is 100:such as small depressions in the nail (pitting), 3152: 1795:"Interventions for treating psoriatic arthritis" 919:A review found tentative evidence of benefit of 907:clinical trial. Takeda also plans to initiate a 432:(sausage-like swelling of the fingers or toes). 269:. Other genes relating to the immune system and 92:. The classic feature of psoriatic arthritis is 2716:Lichenoid reaction of graft-versus-host disease 1264: 1154: 1152: 1150: 1148: 1146: 1144: 1142: 1140: 1138: 1136: 1134: 1132: 1130: 405:Ridging or pitting of fingernails or toenails ( 1406:Journal of the American Academy of Dermatology 1331:Davidson's principles and practice of medicine 1208: 1206: 1204: 1202: 1200: 1198: 1128: 1126: 1124: 1122: 1120: 1118: 1116: 1114: 1112: 1110: 669:) are a class of therapeutics developed using 2746: 2444:Pityriasis lichenoides et varioliformis acuta 2298: 1058:Fitzpatrick's dermatology in general medicine 2955:Systemic-onset juvenile idiopathic arthritis 2312: 1602: 1323: 1268:Quick medical diagnosis & treatment 2023 1219:Journal of the German Society of Dermatology 856:It was patented in 2014 and manufactured by 607:and is disabling in around 50% of all cases. 147:. The condition is less common in people of 2005:The Cochrane Database of Systematic Reviews 1661: 1344: 1195: 1107: 155:descent and affects men and women equally. 2753: 2739: 2305: 2291: 1793:Jones G, Crotty M, Brooks P (2000-07-24). 51: 2024: 1937: 1897: 1836: 1818: 1769: 1720: 1644: 1634: 1519: 1417: 1376: 1230: 547: 2691:Idiopathic eruptive macular pigmentation 348: 317: 292:Current, or history of, severe psoriasis 1870:Cochrane Database of Systematic Reviews 1799:Cochrane Database of Systematic Reviews 106:detachment of the nail from the nailbed 3153: 2760: 1866:"Methotrexate for psoriatic arthritis" 1567: 1265:Papadakis MA, McPhee SJ, eds. (2023). 1074: 744:, followed by more potent NSAIDs like 522:at the upper vertebral endplate of L3. 233:Psoriatic arthritis is an inheritable 85:that occurs in people affected by the 2734: 2286: 2095:, Be Joint Smart (a coalition of the 1969: 1967: 1965: 400:interphalangeal articulations of hand 345:(inflammation of a tendon insertion). 158: 1260: 1258: 1049: 934:) are used for severe skin lesions. 728:Nonsteroidal anti-inflammatory drugs 660: 632:Distal interphalangeal predominant ( 582:inflammation of the sacroiliac joint 1860:Wilsdon TD, Whittle SL, Thynne TR, 1737: 1696: 1089:(10th ed.). Saunders. p.  999:, but it may cause pain around the 914: 94:swelling of entire fingers and toes 13: 2643:Hepatitis-associated lichen planus 2106: 1962: 172:, the distal interphalangeal, the 14: 3187: 2256: 1722:10.1161/CIRCULATIONAHA.106.181424 1255: 930:and long-wave ultraviolet light ( 863: 591: 424:(at the back of the heel) or the 398:Arthritis symptoms in the distal 2357:Pustulosis palmaris et plantaris 2273:National Guideline Clearinghouse 1232:10.1111/j.1610-0387.2009.07334.x 527: 496: 465: 444:Magnetic resonance image of the 437: 16:Long-term inflammatory arthritis 2448:Pityriasis lichenoides chronica 2218:New England Journal of Medicine 2209: 2086: 2041: 1992: 1914: 1853: 1786: 1561: 1536: 1479: 1434: 1215:"Psoriatic arthritis: a review" 1161:New England Journal of Medicine 957: 295:Disease of the finger/toe nails 108:. Skin changes consistent with 2696:Keratosis lichenoides chronica 2686:Erythema dyschromicum perstans 2339:Generalized pustular psoriasis 2017:10.1002/14651858.CD002049.pub2 1882:10.1002/14651858.cd012722.pub2 1393: 1293: 831:cyclic adenosine monophosphate 813:Phosphodiesterase-4 inhibitors 273:may also be involved, such as 1: 2950:Juvenile idiopathic arthritis 2097:National Psoriasis Foundation 1492:Arthritis Care & Research 1042: 827:phosphodiesterase-4 inhibitor 784:Oral small molecules such as 667:biological response modifiers 640: 534:Magnetic resonance images of 2467:Xanthoerythrodermia perstans 2372:Localized pustular psoriasis 1682:10.1016/0002-9343(86)90077-X 1578:10.1007/978-1-4614-4726-9_12 570:systemic lupus erythematosus 307: 7: 2979:Adult-onset Still's disease 2916:Connective tissue disorders 2119:Nature Reviews Rheumatology 1939:10.1093/rheumatology/key333 1025: 428:(bottom of the feet)), and 391:A negative test result for 329:images. Enhancement of the 10: 3192: 2648:Lichen planus pemphigoides 2473:Large plaque parapsoriasis 2459:Small plaque parapsoriasis 2367:Annular pustular psoriasis 1419:10.1016/j.jaad.2008.02.040 772:(MI) or heart attack, and 717:, and the IL-23 inhibitor 578:metacarpophalangeal joints 574:inflammatory bowel disease 311: 20: 3102: 3035: 2991: 2942: 2914: 2881: 2852: 2829: 2820: 2799: 2768: 2676:Lichen ruber moniliformis 2658: 2530: 2520: 2486: 2430: 2418:Seborrheic-like psoriasis 2380: 2329: 2320: 2131:10.1038/s41584-019-0175-0 1811:10.1002/14651858.cd000212 1762:10.1136/bmj.332.7553.1302 1271:. McGraw-Hill Education. 323:Magnetic resonance images 228: 214:in the sole of the foot. 174:metacarpophalangeal joint 64: 59: 50: 42: 37: 2906:Enteropathic arthropathy 2681:Gianotti–Crosti syndrome 2631:with lupus erythematosis 2502:Pityriasis rubra pilaris 2314:Papulosquamous disorders 1615:Proc Natl Acad Sci U S A 170:proximal interphalangeal 2103:). Accessed 2016-11-12. 1636:10.1073/pnas.96.13.7563 926:Photochemotherapy with 921:low level laser therapy 713:, the IL-17A inhibitor 665:Biologics (also called 102:thickening of the nails 2974:Palindromic rheumatism 2901:Ankylosing spondylitis 2844:Tuberculosis arthritis 2477:Retiform parapsoriasis 2454:Lymphomatoid papulosis 2440:Pityriasis lichenoides 2403:Drug-induced psoriasis 2398:Psoriatic erythroderma 2343:Impetigo herpetiformis 2197:Cite journal requires 2074:Cite journal requires 1467:Cite journal requires 1341:. Accessed 2016-11-12. 681:inhibitors, including 548:Differential diagnosis 370: 346: 83:inflammatory arthritis 25:. For other uses, see 2626:with lichen sclerosus 2512:Pityriasis amiantacea 2230:10.1056/nejmra1505557 2172:"Psoriatic Arthritis" 2049:"Psoriatic Arthritis" 1932:(1): e2. 2019-01-01. 1442:"Psoriatic Arthritis" 1301:"Psoriatic Arthritis" 1173:10.1056/NEJMra1505557 770:myocardial infarction 420:(inflammation in the 352: 321: 81:(PsA) is a long-term 2962:Rheumatoid arthritis 2711:Lichenoid dermatitis 2101:Arthritis Foundation 1037:Rheumatoid arthritis 616:rheumatoid arthritis 610:Arthritis mutilans ( 605:rheumatoid arthritis 554:rheumatoid arthritis 375:rheumatoid arthritis 275:interleukin receptor 98:changes to the nails 27:PSA (disambiguation) 3166:Autoimmune diseases 3139:Psoriatic arthritis 2896:Psoriatic arthritis 2463:Digitate dermatosis 2393:Psoriatic arthritis 2263:Psoriatic Arthritis 1627:1999PNAS...96.7563W 1329:Davidson, Stanley, 825:, a small molecule 621:Spondyloarthritis ( 588:when this happens. 281:Bone cells such as 125:spondyloarthropathy 79:Psoriatic arthritis 38:Psoriatic arthritis 3103:External resources 2929:systemic sclerosis 2891:Reactive arthritis 2762:Diseases of joints 2507:Pityriasis rotunda 1311:on 27 January 2016 948:orthopedic surgery 695:certolizumab pegol 562:reactive arthritis 371: 347: 220:arthritis mutilans 159:Signs and symptoms 87:autoimmune disease 3148: 3147: 3029: 3028: 2987: 2986: 2862:Chondrocalcinosis 2728: 2727: 2724: 2723: 2426: 2425: 2408:Inverse psoriasis 2388:Guttate psoriasis 2361:Pustular bacterid 1587:978-1-4614-4725-2 1550:. 5 December 2020 1504:10.1002/acr.23789 1369:10.1002/acr.20207 1278:978-1-264-91671-9 1100:978-0-7216-2921-6 1067:978-0-07-138076-8 952:joint replacement 807:Immunosuppressant 701:, as well as the 661:Biological DMARDs 536:sacroiliac joints 393:rheumatoid factor 366:Bone marrow edema 331:synovial membrane 271:central tolerance 212:plantar fasciitis 76: 75: 32:Medical condition 3183: 3033: 3032: 3014:Bouchard's nodes 2967:Felty's syndrome 2839:Septic arthritis 2827: 2826: 2755: 2748: 2741: 2732: 2731: 2706:Lichen sclerosus 2701:Kraurosis vulvae 2621:overlap synromes 2528: 2527: 2497:Pityriasis rosea 2413:Napkin psoriasis 2327: 2326: 2307: 2300: 2293: 2284: 2283: 2250: 2249: 2213: 2207: 2206: 2200: 2195: 2193: 2185: 2183: 2182: 2168: 2159: 2158: 2110: 2104: 2090: 2084: 2083: 2077: 2072: 2070: 2062: 2060: 2059: 2045: 2039: 2038: 2028: 1996: 1990: 1989: 1987: 1986: 1971: 1960: 1959: 1941: 1918: 1912: 1911: 1901: 1857: 1851: 1850: 1840: 1822: 1790: 1784: 1783: 1773: 1756:(7553): 1302–8. 1741: 1735: 1734: 1724: 1700: 1694: 1693: 1665: 1659: 1658: 1648: 1638: 1606: 1600: 1599: 1565: 1559: 1558: 1556: 1555: 1540: 1534: 1533: 1523: 1483: 1477: 1476: 1470: 1465: 1463: 1455: 1453: 1452: 1438: 1432: 1431: 1421: 1397: 1391: 1390: 1380: 1348: 1342: 1327: 1321: 1320: 1318: 1316: 1307:. Archived from 1305:Arthritis Action 1297: 1291: 1290: 1262: 1253: 1252: 1234: 1210: 1193: 1192: 1156: 1105: 1104: 1088: 1078: 1072: 1071: 1053: 997:Achilles’ tendon 940:joint injections 915:Other treatments 758:COX-2 inhibitors 627:sacroiliac joint 531: 520:Andersson lesion 500: 469: 441: 247:Genomic analysis 55: 35: 34: 23:Piscis Austrinus 3191: 3190: 3186: 3185: 3184: 3182: 3181: 3180: 3151: 3150: 3149: 3144: 3143: 3098: 3097: 3044: 3030: 3025: 3009:Heberden's node 2992:Noninflammatory 2983: 2938: 2910: 2877: 2848: 2816: 2812:Joint stiffness 2795: 2764: 2759: 2729: 2720: 2671:Lichen striatus 2654: 2516: 2482: 2422: 2376: 2316: 2311: 2265:at Patient.info 2259: 2254: 2253: 2224:(10): 957–970. 2214: 2210: 2198: 2196: 2187: 2186: 2180: 2178: 2170: 2169: 2162: 2111: 2107: 2091: 2087: 2075: 2073: 2064: 2063: 2057: 2055: 2047: 2046: 2042: 2011:(4): CD002049. 1997: 1993: 1984: 1982: 1973: 1972: 1963: 1920: 1919: 1915: 1876:(1): CD012722. 1858: 1854: 1805:(3): CD000212. 1791: 1787: 1742: 1738: 1715:(12): 1634–42. 1701: 1697: 1666: 1662: 1607: 1603: 1588: 1566: 1562: 1553: 1551: 1542: 1541: 1537: 1484: 1480: 1468: 1466: 1457: 1456: 1450: 1448: 1440: 1439: 1435: 1398: 1394: 1357:Ann. Rheum. Dis 1349: 1345: 1328: 1324: 1314: 1312: 1299: 1298: 1294: 1279: 1263: 1256: 1211: 1196: 1157: 1108: 1101: 1079: 1075: 1068: 1054: 1050: 1045: 1028: 960: 944:corticosteroids 917: 886:deucravacitinib 866: 815: 782: 730: 671:recombinant DNA 663: 643: 594: 566:gouty arthritis 550: 543: 532: 523: 501: 492: 470: 461: 442: 422:Achilles tendon 358:Achilles tendon 316: 310: 231: 161: 33: 30: 17: 12: 11: 5: 3189: 3179: 3178: 3173: 3168: 3163: 3146: 3145: 3142: 3141: 3130: 3119: 3107: 3106: 3104: 3100: 3099: 3096: 3095: 3084: 3069: 3045: 3040: 3039: 3037: 3036:Classification 3027: 3026: 3024: 3023: 3022: 3021: 3016: 3011: 3004:Osteoarthritis 3001: 2995: 2993: 2989: 2988: 2985: 2984: 2982: 2981: 2976: 2971: 2970: 2969: 2959: 2958: 2957: 2946: 2944: 2940: 2939: 2937: 2936: 2931: 2926: 2920: 2918: 2912: 2911: 2909: 2908: 2903: 2898: 2893: 2887: 2885: 2879: 2878: 2876: 2875: 2870: 2864: 2858: 2856: 2850: 2849: 2847: 2846: 2841: 2835: 2833: 2824: 2818: 2817: 2815: 2814: 2809: 2803: 2801: 2797: 2796: 2794: 2793: 2788: 2786:Oligoarthritis 2783: 2778: 2772: 2770: 2766: 2765: 2758: 2757: 2750: 2743: 2735: 2726: 2725: 2722: 2721: 2719: 2718: 2713: 2708: 2703: 2698: 2693: 2688: 2683: 2678: 2673: 2668: 2666:Lichen nitidus 2662: 2660: 2656: 2655: 2653: 2652: 2651: 2650: 2645: 2635: 2634: 2633: 2628: 2618: 2617: 2616: 2611: 2606: 2601: 2591: 2590: 2589: 2584: 2579: 2574: 2569: 2564: 2554: 2553: 2552: 2547: 2536: 2534: 2525: 2518: 2517: 2515: 2514: 2509: 2504: 2499: 2493: 2491: 2484: 2483: 2481: 2480: 2470: 2456: 2451: 2436: 2434: 2428: 2427: 2424: 2423: 2421: 2420: 2415: 2410: 2405: 2400: 2395: 2390: 2384: 2382: 2378: 2377: 2375: 2374: 2369: 2364: 2353:Acropustulosis 2350: 2335: 2333: 2324: 2318: 2317: 2310: 2309: 2302: 2295: 2287: 2281: 2280: 2275: 2266: 2258: 2257:External links 2255: 2252: 2251: 2208: 2199:|journal= 2160: 2125:(3): 153–166. 2105: 2085: 2076:|journal= 2040: 1991: 1979:Pharmacy Times 1961: 1913: 1864:(2019-01-18). 1852: 1785: 1736: 1695: 1660: 1621:(13): 7563–8. 1601: 1586: 1560: 1535: 1478: 1469:|journal= 1433: 1412:(5): 851–864. 1392: 1343: 1322: 1292: 1277: 1254: 1194: 1167:(10): 957–70. 1106: 1099: 1073: 1066: 1047: 1046: 1044: 1041: 1040: 1039: 1034: 1032:Osteoarthritis 1027: 1024: 993:plantar fascia 959: 956: 916: 913: 876:(Xeljanz) and 865: 864:JAK inhibitors 862: 847:interleukin 10 843:interleukin 23 839:interleukin 17 819:first-in-class 814: 811: 781: 778: 729: 726: 662: 659: 642: 639: 638: 637: 630: 619: 608: 601: 593: 592:Classification 590: 558:osteoarthritis 549: 546: 545: 544: 533: 526: 524: 502: 495: 493: 471: 464: 462: 443: 436: 426:plantar fascia 414: 413: 410: 403: 396: 389: 379:rheumatologist 309: 306: 305: 304: 301: 296: 293: 230: 227: 189:hyperkeratosis 166:oligoarthritis 160: 157: 74: 73: 68: 62: 61: 57: 56: 48: 47: 44: 40: 39: 31: 15: 9: 6: 4: 3: 2: 3188: 3177: 3174: 3172: 3169: 3167: 3164: 3162: 3159: 3158: 3156: 3140: 3136: 3135: 3131: 3129: 3125: 3124: 3120: 3118: 3114: 3113: 3109: 3108: 3105: 3101: 3094: 3090: 3089: 3085: 3083: 3079: 3078: 3074: 3070: 3068: 3064: 3060: 3056: 3055: 3051: 3047: 3046: 3043: 3038: 3034: 3020: 3017: 3015: 3012: 3010: 3007: 3006: 3005: 3002: 3000: 2997: 2996: 2994: 2990: 2980: 2977: 2975: 2972: 2968: 2965: 2964: 2963: 2960: 2956: 2953: 2952: 2951: 2948: 2947: 2945: 2941: 2935: 2932: 2930: 2927: 2925: 2922: 2921: 2919: 2917: 2913: 2907: 2904: 2902: 2899: 2897: 2894: 2892: 2889: 2888: 2886: 2884: 2880: 2874: 2871: 2868: 2865: 2863: 2860: 2859: 2857: 2855: 2851: 2845: 2842: 2840: 2837: 2836: 2834: 2832: 2828: 2825: 2823: 2819: 2813: 2810: 2808: 2805: 2804: 2802: 2798: 2792: 2791:Polyarthritis 2789: 2787: 2784: 2782: 2781:Monoarthritis 2779: 2777: 2774: 2773: 2771: 2767: 2763: 2756: 2751: 2749: 2744: 2742: 2737: 2736: 2733: 2717: 2714: 2712: 2709: 2707: 2704: 2702: 2699: 2697: 2694: 2692: 2689: 2687: 2684: 2682: 2679: 2677: 2674: 2672: 2669: 2667: 2664: 2663: 2661: 2657: 2649: 2646: 2644: 2641: 2640: 2639: 2636: 2632: 2629: 2627: 2624: 2623: 2622: 2619: 2615: 2612: 2610: 2607: 2605: 2602: 2600: 2597: 2596: 2595: 2592: 2588: 2585: 2583: 2580: 2578: 2575: 2573: 2570: 2568: 2565: 2563: 2560: 2559: 2558: 2555: 2551: 2548: 2546: 2543: 2542: 2541: 2540:configuration 2538: 2537: 2535: 2533: 2532:Lichen planus 2529: 2526: 2524: 2519: 2513: 2510: 2508: 2505: 2503: 2500: 2498: 2495: 2494: 2492: 2490: 2485: 2478: 2474: 2471: 2468: 2464: 2460: 2457: 2455: 2452: 2449: 2445: 2441: 2438: 2437: 2435: 2433: 2432:Parapsoriasis 2429: 2419: 2416: 2414: 2411: 2409: 2406: 2404: 2401: 2399: 2396: 2394: 2391: 2389: 2386: 2385: 2383: 2379: 2373: 2370: 2368: 2365: 2362: 2358: 2354: 2351: 2348: 2344: 2340: 2337: 2336: 2334: 2332: 2328: 2325: 2323: 2319: 2315: 2308: 2303: 2301: 2296: 2294: 2289: 2288: 2285: 2279: 2276: 2274: 2270: 2267: 2264: 2261: 2260: 2247: 2243: 2239: 2235: 2231: 2227: 2223: 2219: 2212: 2204: 2191: 2177: 2173: 2167: 2165: 2156: 2152: 2148: 2144: 2140: 2136: 2132: 2128: 2124: 2120: 2116: 2109: 2102: 2098: 2094: 2093:Who's At Risk 2089: 2081: 2068: 2054: 2050: 2044: 2036: 2032: 2027: 2022: 2018: 2014: 2010: 2006: 2002: 1995: 1980: 1976: 1970: 1968: 1966: 1957: 1953: 1949: 1945: 1940: 1935: 1931: 1927: 1923: 1917: 1909: 1905: 1900: 1895: 1891: 1887: 1883: 1879: 1875: 1871: 1867: 1863: 1856: 1848: 1844: 1839: 1834: 1830: 1826: 1821: 1816: 1812: 1808: 1804: 1800: 1796: 1789: 1781: 1777: 1772: 1767: 1763: 1759: 1755: 1751: 1747: 1740: 1732: 1728: 1723: 1718: 1714: 1710: 1706: 1699: 1691: 1687: 1683: 1679: 1675: 1671: 1664: 1656: 1652: 1647: 1642: 1637: 1632: 1628: 1624: 1620: 1616: 1612: 1605: 1597: 1593: 1589: 1583: 1579: 1575: 1571: 1564: 1549: 1545: 1539: 1531: 1527: 1522: 1517: 1513: 1509: 1505: 1501: 1497: 1493: 1489: 1482: 1474: 1461: 1447: 1443: 1437: 1429: 1425: 1420: 1415: 1411: 1407: 1403: 1396: 1388: 1384: 1379: 1374: 1370: 1366: 1363:(5): 664–75. 1362: 1358: 1354: 1347: 1340: 1339:9780702030857 1336: 1332: 1326: 1310: 1306: 1302: 1296: 1288: 1284: 1280: 1274: 1270: 1269: 1261: 1259: 1250: 1246: 1242: 1238: 1233: 1228: 1224: 1220: 1216: 1209: 1207: 1205: 1203: 1201: 1199: 1190: 1186: 1182: 1178: 1174: 1170: 1166: 1162: 1155: 1153: 1151: 1149: 1147: 1145: 1143: 1141: 1139: 1137: 1135: 1133: 1131: 1129: 1127: 1125: 1123: 1121: 1119: 1117: 1115: 1113: 1111: 1102: 1096: 1092: 1087: 1086: 1077: 1069: 1063: 1059: 1052: 1048: 1038: 1035: 1033: 1030: 1029: 1023: 1021: 1016: 1014: 1013:supraspinatus 1010: 1006: 1002: 998: 994: 990: 986: 984: 978: 976: 971: 967: 965: 955: 953: 949: 945: 941: 937: 933: 929: 924: 922: 912: 910: 906: 902: 898: 895: 891: 887: 883: 879: 875: 871: 861: 859: 854: 850: 848: 844: 840: 836: 832: 828: 824: 820: 810: 808: 803: 802:sulfasalazine 799: 795: 791: 787: 777: 775: 771: 767: 763: 759: 755: 751: 747: 743: 739: 735: 725: 722: 720: 716: 712: 708: 704: 700: 696: 692: 688: 684: 680: 675: 672: 668: 658: 656: 655:TNF inhibitor 652: 648: 635: 631: 628: 624: 620: 617: 613: 609: 606: 602: 599: 598: 597: 589: 587: 583: 579: 575: 571: 567: 563: 559: 555: 541: 537: 530: 525: 521: 517: 513: 510: 506: 499: 494: 490: 489:tendon sheath 486: 485:tenosynovitis 483: 479: 475: 468: 463: 459: 455: 451: 447: 440: 435: 434: 433: 431: 427: 423: 419: 411: 408: 404: 401: 397: 394: 390: 387: 386: 385: 382: 380: 376: 367: 363: 359: 355: 351: 344: 340: 336: 332: 328: 324: 320: 315: 302: 300: 297: 294: 291: 290: 289: 286: 284: 279: 276: 272: 268: 264: 260: 256: 252: 248: 244: 241: 240:immune system 236: 226: 223: 221: 215: 213: 209: 205: 201: 197: 192: 190: 186: 182: 177: 175: 171: 167: 156: 154: 150: 146: 143: 138: 136: 132: 128: 126: 123: 119: 116:, scaly, and 115: 111: 107: 103: 99: 95: 91: 88: 84: 80: 72: 69: 67: 63: 58: 54: 49: 45: 41: 36: 28: 24: 19: 3176:Rheumatology 3132: 3121: 3110: 3086: 3071: 3048: 2999:Hemarthrosis 2895: 2883:Seronegative 2869:(Pseudogout) 2822:Inflammatory 2637: 2620: 2614:Vulvovaginal 2609:Peno-ginival 2593: 2562:Hypertrophic 2556: 2539: 2392: 2221: 2217: 2211: 2190:cite journal 2179:. Retrieved 2122: 2118: 2108: 2088: 2067:cite journal 2056:. Retrieved 2043: 2008: 2004: 1994: 1983:. Retrieved 1981:. 2023-11-08 1978: 1929: 1926:Rheumatology 1925: 1916: 1873: 1869: 1855: 1802: 1798: 1788: 1753: 1749: 1739: 1712: 1708: 1698: 1676:(4B): 34–8. 1673: 1669: 1663: 1618: 1614: 1604: 1569: 1563: 1552:. Retrieved 1547: 1538: 1495: 1491: 1481: 1460:cite journal 1449:. Retrieved 1436: 1409: 1405: 1395: 1360: 1356: 1346: 1325: 1313:. Retrieved 1309:the original 1304: 1295: 1267: 1225:(5): 332–9. 1222: 1218: 1164: 1160: 1084: 1076: 1057: 1051: 1017: 987: 979: 972: 968: 961: 958:Epidemiology 932:PUVA therapy 925: 918: 878:upadacitinib 867: 855: 851: 816: 798:azathioprine 786:methotrexate 783: 750:indomethacin 731: 723: 719:risankizumab 676: 664: 651:inflammation 647:inflammation 644: 595: 551: 540:sacroiliitis 446:index finger 415: 383: 372: 287: 280: 245: 232: 224: 216: 200:sacroiliitis 193: 178: 162: 139: 129: 122:seronegative 78: 77: 71:Rheumatology 18: 3112:MedlinePlus 1709:Circulation 1498:(1): 2–29. 1015:insertions 1009:epicondyles 1005:iliac crest 983:onycholysis 928:methoxsalen 874:tofacitinib 872:inhibitors 794:cyclosporin 790:leflunomide 715:secukinumab 711:ustekinumab 407:onycholysis 360:insertion ( 283:osteoclasts 251:class I MHC 204:spondylitis 185:onycholysis 43:Other names 3155:Categories 3134:Patient UK 3019:Osteophyte 2831:Infectious 2807:Joint pain 2577:Ulcerative 2557:morphology 2489:pityriasis 2181:2011-05-04 2058:2011-05-04 1985:2023-11-08 1862:Mangoni AA 1820:2328/39181 1670:Am. J. Med 1554:2021-04-06 1451:2011-05-04 1287:1349393887 1163:(Review). 1043:References 989:Enthesitis 899:inhibitor 884:inhibitor 823:apremilast 766:etoricoxib 746:diclofenac 709:inhibitor 699:adalimumab 687:etanercept 683:infliximab 641:Treatments 586:pseudogout 507:and lower 478:dactylitis 430:dactylitis 418:enthesitis 362:enthesitis 343:enthesitis 312:See also: 253:including 208:enthesitis 181:dactylitis 3171:Psoriasis 3161:Arthritis 3128:radio/578 3123:eMedicine 3065:.0–.3 or 2934:Sjögren's 2776:Arthritis 2587:Pigmented 2523:lichenoid 2322:Psoriasis 2176:WebMD LLC 2139:1759-4790 1948:1462-0324 1890:1465-1858 1829:1465-1858 1512:2151-464X 1315:12 August 1020:psoriasis 975:psoriasis 964:psoriasis 909:Phase III 762:celecoxib 738:ibuprofen 691:golimumab 335:synovitis 308:Diagnosis 235:polygenic 110:psoriasis 90:psoriasis 66:Specialty 2800:Symptoms 2567:Atrophic 2331:Pustular 2246:43867408 2238:28273019 2155:59945330 2147:30742092 2099:and the 2035:16235295 1956:30380114 1908:30656673 1847:10796328 1780:16740558 1731:17325246 1655:10377455 1596:23654064 1530:30499259 1428:18423261 1387:20461787 1249:25484225 1241:20015187 1189:43867408 1181:28273019 1026:See also 938:may use 905:Phase II 890:Phase II 754:etodolac 742:naproxen 736:such as 618:as well. 516:anterior 509:thoracic 450:sagittal 369:arrows). 354:Sagittal 267:HLA-B*39 263:HLA-B*38 259:HLA-B*27 255:HLA-B*08 145:genotype 142:HLA-B*27 131:Genetics 3093:D015535 2854:Crystal 2769:General 2599:Mucosal 2582:Actinic 2572:Bullous 2545:Annular 2026:8406947 1899:6353064 1838:7043365 1771:1473048 1690:3085490 1623:Bibcode 1521:8265826 1378:2962800 1001:patella 936:Doctors 901:TAK-279 858:Celgene 760:) e.g. 480:due to 454:phalanx 327:coronal 299:Obesity 153:African 135:Obesity 112:(e.g., 3117:000413 2638:other: 2550:Linear 2521:Other 2487:Other 2244:  2236:  2153:  2145:  2137:  2033:  2023:  1954:  1946:  1906:  1896:  1888:  1845:  1835:  1827:  1778:  1768:  1729:  1688:  1653:  1643:  1594:  1584:  1528:  1518:  1510:  1426:  1385:  1375:  1337:  1285:  1275:  1247:  1239:  1187:  1179:  1097:  1064:  1011:, and 894:Takeda 800:, and 774:stroke 752:, and 734:NSAIDs 572:, and 505:lumbar 482:flexor 339:medial 265:, and 229:Causes 196:sacrum 104:, and 3082:696.0 3067:M09.0 3061:with 3059:L40.5 2943:Other 2659:Other 2604:Nails 2381:Other 2242:S2CID 2151:S2CID 1646:22126 1245:S2CID 1185:S2CID 942:with 835:TNF-α 707:IL-23 703:IL-12 679:TNF-α 634:M07.0 623:M07.2 612:M07.1 512:spine 474:axial 458:edema 149:Asian 118:itchy 3088:MeSH 3077:9-CM 2873:Gout 2867:CPPD 2594:site 2234:PMID 2203:help 2143:PMID 2135:ISSN 2080:help 2031:PMID 2009:2010 1952:PMID 1944:ISSN 1904:PMID 1886:ISSN 1843:PMID 1825:ISSN 1803:2000 1776:PMID 1727:PMID 1686:PMID 1651:PMID 1592:PMID 1582:ISBN 1548:AJMC 1526:PMID 1508:ISSN 1473:help 1424:PMID 1383:PMID 1335:ISBN 1317:2015 1283:OCLC 1273:ISBN 1237:PMID 1177:PMID 1095:ISBN 1062:ISBN 995:and 897:TYK2 882:TYK2 870:JAK1 868:The 841:and 740:and 697:and 377:. 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Index

Piscis Austrinus
PSA (disambiguation)

Specialty
Rheumatology
inflammatory arthritis
autoimmune disease
psoriasis
swelling of entire fingers and toes
changes to the nails
thickening of the nails
detachment of the nail from the nailbed
psoriasis
red
itchy
seronegative
spondyloarthropathy
Genetics
Obesity
HLA-B*27
genotype
Asian
African
oligoarthritis
proximal interphalangeal
metacarpophalangeal joint
dactylitis
onycholysis
hyperkeratosis
sacrum

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