At the onset of psoriasis, a symptom such as the dactylitisinflammation of the fingers and toes that take on a “sausage-like” appearance, would be indicative of a more severe form of the disease, namely thepsoriatic arthritis. This is what is reported in an article published on the Allies for Health website (www.alleatiperlasalute.it) the portal dedicated to medical-scientific information created by Novartis, which incorporates the results of a study conducted by researchers of the Musculoskeletal Biomedical Research Center of Leeds (United Kingdom), according to which dactylitis would be independently linked to a more severe form and to more extensive bone erosion processes in which it occurs at the onset of psoriasistherefore not yet treated (naïve) with therapies capable of slowing the progression of psoriatic disease (Dmard, Disease-modifying antirheumatic drugs).
Not only. The results of the study, which involved 177 patients divided according to the initial presence / absence of the inflammatory manifestation (81 with dactylitis) – reads the article – could be particularly useful for the assessment of the state and evolution of psoriasis from the first diagnosisbut also for the definition of the subjects to be involved in randomized clinical trials on the efficacy and safety of new treatments.
In the introduction, the authors of the study report that “the presence of a history of dactylitis adds greater sensitivity and specificity in the classification process of psoriasis (Caspar criteria)” because “it is associated with greater radiographic damage in patients with chronic overt psoriatic disease. Until now, however, a direct evaluation of the impact of this symptom on the manifestation and severity of the disease in its entirety had never been carried out in patients at the onset of psoriasis and not yet treated “.
From the data it emerges – we read in the article – that subjects with dactylitis had more painful than swollen joints and higher levels of C-reactive protein (Pcr), which signals acute inflammation, compared to those without fingers and toes with the typical swelling. Furthermore, dactylitis was more present in the toes than in the hands (68.2% vs. 31.8%). On these manifestations, another aspect observed by the researchers indicates that “hot” dactylitis (characterized by pain) was more prevalent than “cold” (not painful) (83.4% compared to 16.4%). Finally, both synovitis and bone erosions, measured by ultrasound, were more frequent in patients with dactylitis. On the other hand, no substantial differences were found with regard to ultrasound enthesitis.
The authors of the study conclude that “dactylitis should be considered, to all intents and purposes, a clinical marker of more severe disease manifestation in patients with onset psoriasis, and an important discriminating factor for risk stratification in coping strategies. pharmacological intervention “.
The full article is available on: https://www.alleatiperlasalute.it/diagnosi/artrite-psoriasica-la-dattilite-allesordio-e-indice-di-malattia-piu-severa
#Dactylitis #onset #psoriasis #indicative #psoriatic #arthritis