[Psoriatic rheumatism].

Abstract

Five to seven per cent of patients with cutaneous psoriasis develop a seronegative inflammatory arthritis which is often erosive and frequently both peripheral and axial. The most common peripheral type of psoriatic arthritis is represented by asymmetrical oligoarthritis, the localisation most suggestive of psoriasis being distal interphalangeal arthritis. Symmetrical polyarthritis may also be observed. Severe and mutilating forms of the disease are fortunately rare. Te axial type of psoriatic arthritis consists of a usually bilateral sacroiliitis and/or spinal lesions which may result in ankylosing spondylitis. Most cases of psoriatic arthritis are treated with non-steroidal anti-inflammatory drugs alone and local treatments. Corticosteroid therapy must be administered with caution and restricted to the severe forms. A fairly large number of maintenance treatments for peripheral arthritis have been used, not always after controlled trials; the most commonly prescribed are gold salts, sulphasalazine and methotrexate.