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Juvenile psoriatic arthritis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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A diagnosis of psoriatic arthritis is made in the presence of arthritis together with either a psoriatic rash or two of the following: dactylitis; nail pitting or onycholysis; psoriasis in a first-degree relative

  • diagnosis may be challenging since skin manifestations appear few years later after articular involvement

In patients with juvenile psoriatic arthritis:

  • articular involvement may vary e.g - from symmetrical small-joint arthritis to asymmetrical lower-extremity large-joint arthritis and finally may progress to polyarthritis mimicking seropositive rheumatoid arthritis.
  • dactylitis (“sausage-like” fingers) is caused by arthritis of metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of one or more fingers
  • features of enthesitis related arthritis may be present e.g. - enthesitis, sacroiliitis, spondylitis etc
  • psoriatic plaques are usually present on the extensor sides of joints, haired skin, the umbilicus and the perineum
  • nail changes are common e.g. - nail dystrophy, subungual hyperkeratosis and onycholysis

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