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      Cambios radiográficos en el penacho de la falange distal de las manos en pacientes con psoriasis o artritis psoriásica. Revisión sistemática Translated title: Radiographic changes in the distal phalanx tuft of the hands in subjects with psoriasis or psoriatic arthritis. Systematic review


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          Resumen Introducción. El penacho de la falange distal de las manos (PFDM) es una estructura ósea que sufre cambios sutiles en diversas enfermedades musculoesqueléticas. Hasta el momento, se desconoce el tipo y frecuencia de las lesiones del PFDM en psoriasis y artritis psoriásica (APs). Objetivo. Determinar en radiografía simple las anormalidades del PFDM en adultos con psoriasis y APs. Materiales y métodos. Se realizó una revisión sistemática buscando alteraciones radiográficas del PFDM en adultos con psoriasis y APs. La prevalencia de los hallazgos fue sintetizada usando un modelo de efectos fijos. Las asociaciones se expresaron como odds ratio (OR) con intervalos de confianza (IC) y valores p. Resultados. Se incluyeron 11 estudios observacionales. La alteración de mayor frecuencia en APs fue la resorción del PFDM con una prevalencia del 16%. El compromiso del PFDM en sujetos con onicopatía psoriásica fue mayor que en sujetos sin compromiso ungueal (OR=2.91; IC95%: 1.04-8.13; p=0.04), siendo las erosiones y la esclerosis los hallazgos de mayor importancia. Conclusión. La evidencia actual acerca del compromiso del PFDM en APs y psoriasis es limitada. Existe relación entre las alteraciones del PFDM y la patología ungueal en donde las erosiones y la esclerosis son las anormalidades más significativas.

          Translated abstract

          Abstract Introduction: The distal phalanx tuft of the hand (DPTH) is a bone structure that undergoes subtle changes in various musculoskeletal diseases. To date, the type and frequency of DPTH injuries involved in psoriasis and psoriatic arthritis (PsA) are unknown. Objective: To determine the abnormal findings related to DPTH through plain X-rays in adult subjects with psoriasis and psoriatic arthritis (PsA). Materials and methods: A systematic review of radiographic alterations of the DPTH detected in plain hand radiographs was performed following the PRISMA guidelines. The prevalence of findings was summarized using a fixed effects model. Statistical associations were expressed as odds ratio (OR) with confidence intervals (CI) and p values. Results: Eleven observational studies were included. The most frequent alteration in PsA was DPTH resorption with a prevalence of 16%. The involvement of DPTH in subjects with psoriatic onicopathy was higher than in subjects without ungueal affectation (OR=2.91, 95%CI: 1.04-8.13; p=0.04), being erosions and sclerosis the most important findings. Conclusion: Current evidence regarding DPTH involvement in PsA and psoriasis is limited. However, an apparent correlation between DPTH findings and ungual abnormalities could exist, where erosions and sclerosis are the most significant abnormalities.

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          Most cited references45

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            The Epidemiology of Psoriatic Arthritis.

            Psoriatic arthritis (PsA) is a chronic systemic inflammatory disorder characterized by joint and entheseal inflammation with a prevalence of 0.05% to 0.25% of the population and 6% to 41% of patients with psoriasis. PsA is a highly heterogeneous inflammatory arthritis. In this review, current knowledge is discussed regarding the epidemiology of PsA, including disease manifestations, classification criteria for adult and juvenile PsA, methods for recognizing early PsA, including use of screening tools and knowledge of risk factors for PsA, and medical comorbidities associated with PsA.
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              Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study.

              To determine the incidence and disease-specific predictors of clinically recognized psoriatic arthritis (PsA) in patients with psoriasis. We identified an incidence cohort of psoriasis subjects age >/=18 years diagnosed between January 1, 1970 and December 31, 1999 in a population-based setting. Psoriasis diagnoses were validated by confirmatory diagnosis in the medical record. Incident and clinically recognized PsA subjects were classified according to the Classification of Psoriatic Arthritis (CASPAR) criteria. Cox proportional hazards models were used to identify predictors of PsA within the psoriasis cohort. The psoriasis incidence cohort comprised 1,633 subjects. Of these, 40 were diagnosed with PsA concurrently with psoriasis and were excluded from analysis. The remaining 1,593 psoriasis subjects had a mean age of 43 years and 50% were men. Over 20,936 person-years of followup, 57 subjects were clinically recognized with new-onset PsA, with a cumulative incidence of 1.7% (95% confidence interval [95% CI] 1.0-2.3%), 3.1% (95% CI 2.2-4.1%), and 5.1% (95% CI 3.7-6.6%) at 5, 10, and 20 years following psoriasis incidence, respectively. Psoriasis features associated with higher risk of PsA were scalp lesions (hazard ratio [HR] 3.89, 95% CI 2.18-6.94), nail dystrophy (HR 2.93, 95% CI 1.68-5.12), and intergluteal/perianal lesions (HR 2.35, 95% CI 1.32-4.19). Calendar year was not associated with risk of PsA (P = 0.15), indicating that the likelihood of PsA in psoriasis subjects did not change over time. In this population-based study, <10% of patients with psoriasis developed clinically recognized PsA during a 30-year period. Psoriasis features associated with a higher likelihood of PsA were nail dystrophy, scalp lesions, and intergluteal/perianal psoriasis.

                Author and article information

                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Revista de la Facultad de Medicina
                Universidad Nacional de Colombia (Bogotá, Distrito Capital, Colombia )
                June 2017
                : 65
                : 2
                : 349-357
                [1] Bogotá orgnameUniversidad Nacional de Colombia orgdiv1Facultad de Medicina orgdiv2Departamento de Imágenes Diagnósticas Colombia
                [2] Bogotá orgnameUniversidad Nacional de Colombia orgdiv1Facultad de Medicina orgdiv2Departamento de Imágenes Diagnósticas Colombia

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                : 21 July 2016
                : 24 October 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 48, Pages: 9

                SciELO Colombia

                Radiography,Psoriasis,Artritis psoriásica,Radiografía,Falanges de los dedos de la mano (DeCS),Arthritis, Psoriatic,Finger Phalanges,Hand (MeSH)


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