Clinical remission of psoriatic arthritis in patients receiving continuous biological therapies for 1 year: the experience of an outpatient dermatological clinic for psoriasis.

BACKGROUND: The data in the literature concerning the frequency of remission of inflammatory arthritis in patients with psoriatic arthritis (PsA) are limited and conflicting. AIM: To evaluate the frequency of clinical remission in inflammatory arthritis in a cohort of patients with PsA receiving continuous treatment (1 year) with tumour necrosis factor-α inhibitors or ustekinumab, as well as the clinical covariates affecting remission. METHODS: We retrospectively evaluated 74 patients with PsA attending our psoriasis outpatient dermatology clinic. Remission of PsA was defined as documented absence of clinical signs related to arthritis (no tender or swollen joints), enthesitis or dactylitis. Patients were examined every 3 months for 1 year. RESULTS: At 1 year > 40% of patients had clinical remission of inflammatory arthritis. Predictors of remission were absence of fibromyalgia (FM) at baseline and having < 11 tender joints. CONCLUSIONS: Clinical remission of inflammatory arthritis can be obtained in a significant proportion of patients by continuous treatment with biological drugs. A large number of tender joints and the presence of FM can make remission less likely.

The diagnosis of early psoriatic arthritis in an outpatient dermatological centre for psoriasis.

BACKGROUND: Most of the data currently available on early psoriatic arthritis (EPsA) derive from studies performed in rheumatological settings. However, in recent years, there has been an increase in the amount of data from dermatologic centres. OBJECTIVES: To describe the prevalence, clinical, laboratory and imaging characteristics of psoriatic patients with EPsA seen at a dermatological outpatient psoriasis centre. METHODS: From January 2007 to May 2010, all patients with psoriasis who visited the psoriasis centre were asked about inflammatory joint involvement. A diagnosis of psoriatic arthritis was made on the basis of clinical, laboratory and imaging studies. The patients were diagnosed with early PsA (EPsA) if their inflammatory articular symptoms had been present for ≤ 1 year. RESULTS: We diagnosed EPsA in 33 patients. Joint involvement was polyarticular (>5 joints involved) in 20 patients (60.6%) and oligoarticular (≤5 joints involved) in the remaining 13 patients. Quality of life due to skin involvement and the degree of functional impairment due to joint inflammation were only mildly affected, as measured by DLQI and HAQ, respectively. A direct correlation between the number of tender joints (ACR 68) and HAQ was found (r = 0.36; P = 0.04). Imaging studies showed that in spite of the absence of radiologic findings of peripheral joint damage, ultrasonography and contrast enhanced ultrasonography showed signs of articular inflammation in all patients. CONCLUSIONS: A diagnosis of EPsA can be correctly performed in a dermatologic outpatient facility. To do so, a close collaboration among dermatologists, rheumatologists and radiologists is necessary.

Polyarticular pigmented villonodular synovitis associated with multiple congenital anomalies. A case of Noonan-like/multiple giant cell lesion syndrome.

A case of polyarticular pigmented villonodular synovitis associated with many congenital phenotypic peculiarities (such as shortness, blue sclerae, flattened nose, low-set ears, hypertelorism, curly hair and pulmonary stenosis) is described. The presence of many of the typical signs of the Noonan syndrome and the histological finding of giant cells on the synovial biopsy led to the diagnosis of Noonan-like/multiple giant cell lesion syndrome.

Atypical renal onset and involvement in primary antiphospholipid syndrome in a child.

A case of primary antiphospholipid syndrome (APS) with renal involvement in a 10-year-old child is reported. The peculiarity of the case resided not only in the apparent "primary" occurrence of APS in the pediatric age, but also in the involvement of the kidney. The renal picture in the case described consisted of a focal proliferative glomerulonephritis, without any sign of glomerular thrombosis. We conclude that this should lead to a consideration of primary APS in the differential diagnosis of nephropathies, also in childhood.

Viral infections in a sample of intravenous drug abuser prisoners.

The Authors point out the high frequency of viral infections in a sample of IVDAs. The most significant infections that emerged are CMV and HCV diseases, in contrast with other epidemiological studies.

The glycocalyx of the epithelial cells of the colon, observed in normal and ulcerous colitic conditions.

Biopsies of subjects affected by ulcerous colitis were stained with ruthenium Red. Alterations of the cellular coat and glycocalyx of the epithelial cells of the colon were identified.