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Psoriasisarthritis

Eine interdisziplinäre Herausforderung

Psoriasis arthritis

An interdisciplinary challenge

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Zusammenfassung

Die Psoriasisarthritis (PsA) wird aufgrund ihrer klinischen und serologischen Eigenschaften zur Gruppe der seronegativen Spondylarthritiden gezählt. Die Abgrenzung der PsA von anderen Arthritiden ergibt sich aus den Besonderheiten bei der klinischen Manifestation, der Assoziation mit Psoriasis oder Nagelpsoriasis und möglicherweise auch immunologischen Charakteristika. Das pathophysiologische und genetische Verständnis wurde in den letzten Jahren durch die Entwicklung innovativer medikamentöser Therapiestrategien bei rheumatoider Arthritis und Psoriasis stark vorangetrieben. Durch die zunehmende Interdisziplinarität zwischen Dermatologen und Rheumatologen konnte für die Versorgungsnotwendigkeit dieser Erkrankung ein zunehmendes Bewusstsein generiert werden. Medikamentöse Therapiestrategien, basierend auf konkreten Behandlungsempfehlungen und -pfaden, können sowohl klinischen Symptomen als auch den radiologischen Progressionen wirksam begegnen und den Funktionserhalt der Gelenke fördern.

Abstract

Psoriatic arthritis (PsA) is classified as a spondylarthropathy based on its clinical and serological characteristics. The clinical manifestations and the association with psoriasis or nail psoriasis have led, together with immunological characteristics, to a further differentiation. The pathophysiological and genetic understanding of this disease has advanced as a result of the development of new treatment strategies and targets in rheumatology and dermatology. Collaborative efforts and increasing multidisciplinary cooperation between rheumatologists and dermatologists have led to an increased awareness in early diagnosis and treatment. New treatment modalities have demonstrated significant efficacy in preventing radiologic progression resulting in amelioration of clinical symptoms, improvement of function and quality of life.

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Abbreviations

ACR:

Arthritis-Score der Amerikanischen Rheumagesellschaft

AS:

Ankolysierende Spondylitis

BASDAI:

„Bath Ankylosing Spondylitis Disease Activity Index“

CASPAR:

„Classification of Psoriatic Arthritis Criteria“

CT:

Computertomographie

CRMO:

Chronisch rekurrierende multifokale Osteomyelitis

DAS:

„Disease Activity Index“

DLQI:

„Dermatology Life Quality Index“

DMARDs:

„Disease-modifying antirheumatic drugs“

EULAR:

„European League Against Rheumatism“

GRAPPA:

„Group for Research and Assessment of Psoriasis and Psoriatic Arthritis“

HAQ:

„Health Assessment Questionnaire“

HLA-System:

„Human leucocyte antigen“-System

JIA:

Juvenile idiopathische Arthritis

MC:

M. Crohn

MRT:

Magnetresonanztomographie

MTX:

Methotrexat

NSARs:

Nichtsteroidale Antirheumatika

PASE:

„Psoriatic Arthritis Screening and Evaluation“

PASI:

„Psoriasis Area and Severity Index“

PEST:

„Psoriasis Epidemiology Screening Tool“

POPP:

Psoriatische Onychopachydermoperiostitis

PsA:

Psoriasisarthritis

PsO:

Psoriasis

RA:

Rheumatoide Arthritis

RF:

Rheumafaktor

SCCH:

Sternokostoklavikuläre Hyperostose

TNF-α:

Tumornekrosefaktor-α

ToPAS:

„Toronto Psoriatic Arthritis Screening Questionnaire“

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: PD Dr. M.A. Radtke, Prof. Dr. K. Reich und Prof. Dr. M. Augustin sind oder waren als Referenten für die Firmen Abbott, MSD, Pfizer, Biogen, Medac und Janssen tätig und führten oder führen im Auftrag dieser Firmen klinische und versorgungswissenschaftliche Studien durch.

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Authors and Affiliations

  1. Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen – IVDP, Competenzzentrum Versorgungsforschung in der Dermatologie – CVderm, Universitätsklinikum Hamburg – Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    M.A. Radtke, F. Beikert & M. Augustin

  2. Dermatologikum Hamburg, Hamburg, Deutschland

    K. Reich

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  1. M.A. Radtke
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  2. K. Reich
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  3. F. Beikert
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  4. M. Augustin
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Correspondence to M.A. Radtke.

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Radtke, M., Reich, K., Beikert, F. et al. Psoriasisarthritis. Hautarzt 62, 779–792 (2011). https://doi.org/10.1007/s00105-011-2243-5

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