DOI: https://doi.org/10.22141/1608-1706.3.21.2020.208422

Psoriatic spondylitis and ankylosing spondylitis with psoriasis: common ground

Ye.D. Yehudina, S.А. Trypilka

Abstract


The term “spondyloarthritis” (SpA) includes a group of related diseases such as ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis, SpA associated with inflammatory bowel disease, undifferentiated SpA and non-radiographic axial SpA. AS was first identified in the late 17th century. After 250 years, inflammatory disease of the spine was recognized as one of the patterns of psoriatic arthritis (PsA). Isolated spondylitis is rare in patients with PsA, its frequency is less than 5 %; however, many patients with PsA have an axial lesion that accompanies peripheral arthritis. At the same time, 10 % of patients with AS have psoriasis. Although axial involvement in PsA may be indistinguishable from that in AS, it has a number of characteristic features, which raises the question of whether axial PsA and AS (with or without psoriasis) are different clinical manifestations of the same disease, or they are individual diseases that have overlapping features. In this review, we highlighted the similarities and differences between the clinical picture, genetic factors, radiological characteristics, treatment options and prognosis for both AS and axial PsA, based on all comparative studies available to date. In general, available studies have shown that clinically, radiologically, and prognostically, axial damage in patients with AS is more severe than in patients with axial PsA, whereas axial PsA is usually associated with the higher degree of peripheral disease. However, it is unclear whether these differences are due to differences in the cohorts of patients included in the comparative analyzes (individuals with axial PsA are usually older and have fewer symptoms than patients with AS), or emphasize the true differences between the diseases.

Keywords


spondyloarthritis; ankylosing spondylitis; psoriatic arthritis; psoriasis; sacroiliitis; spondylitis; review

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