Psoriatic JIA

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Psoriatic arthritis is classified as arthritis associated with psoriasis or arthritis and at least two of the following: dactylitis [i.e., when the whole digit (toe or finger) is swollen as a result of inflammation in the digital joints and associated tendon sheaths], nail pitting or onycholysis, and/or psoriasis in a first-degree relative. Arthritis may predate the onset of psoriasis by many years in the juvenile form. Even if psoriasis is present, it may be limited in its extent (e.g., natal cleft or scalp).

There are differences between juvenile- and adult-onset psoriatic arthritis in terms of association with chronic anterior uveitis in the juvenile

Table 4 Comparison of Enthesitis-Related Arthritis and Related Adult Disorders

Disorder

Table 4 Comparison of Enthesitis-Related Arthritis and Related Adult Disorders

Disorder

Enthesitis-

Ankylosing

Psoriatic

Colitis-related

Characteristics

related JIA

spondylitis

arthritis

arthritis

HLA-B27

85%

90%

-50%

-50%

positive

Sacroiliitis

< 50%

100%

20%

< 20%

Peripheral joint

90%

25%

95%

Source: Adapted from Ref. 20.

involvement

Source: Adapted from Ref. 20.

form and HLA associations (22,23). It is more likely that psoriasis is present either before or at the onset of joint symptoms (90%) in the adult form than in the juvenile form.

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