Currently, the prevalence of PsA in the population is 0.05-1.6%. In terms of the rate of progression, deterioration of the quality of life and disability, PsA patients are comparable to rheumatoid arthritis and ankylosing spondylitis. Purpose: to study the effect of psoriatic arthritis on the quality of life of patients. Materials and methods. A study was conducted with the participation of 75 patients. For the study, we used standardized questionnaires developed to assess the quality of life of patients with PsA. Research method - questioning patients using standardized questionnaires, analysis of the information received. Results. Psoriatic arthritis has a significant impact on the quality of life of patients, affecting the physical, social and emotional spheres. The most important areas of influence of psoriatic arthritis from the point of view of patients are: pain (78%), skin problems (72%), decreased functionality (60%), discomfort (51%) and fatigue (44%). In patients with PsA, pronounced functional disorders are noted. The HAQ index in men averaged 1.98 0.86 (from 1.12 to 2.84 points), in women - 1.77 0.34 (from 1.44 to 2.11 points) (p 0.0001). The pain syndrome according to the VAS averaged 74.34 9.22 mm in men, and 65.77 8.19 mm in women. Patients noted the greatest disturbances in such activities as walking (44%), standing up (37%), hygiene procedures (21%), using transport (36%), housework (47%). Almost 40% of patients use various devices or the help of others (p 0.0001). Psoriatic arthritis also affects the emotional sphere of life. Subclinical emotional disorders were more often detected in women than in men (symptoms of anxiety - 61.9% and 42.2%, depression - 71.4% and 39.4%, respectively); however, approximately the same number of men had clinically expressed signs of depression ( 12.1%) and women (11.9%). Psoriatic arthritis significantly reduces the quality of life, affecting the most important aspects of it - physical, emotional and social.
An increased risk of cardiovascular events has now been identified in patients with psoriatic arthritis. The chronic immune-mediated inflammation underlying psoriatic arthritis (PA) leads to the development of dyslipidemia, atherosclerosis and its complications, in particular, a high risk of cardiovascular complications. For PA, dyslipidemias are most characteristic, manifested by an increased level of low and very low density lipoproteins, triglycerides and total cholesterol, which correlates with the activity of the disease. The literature review studied the pathogenesis of dyslipidemias and vascular wall lesions in psoriatic arthritis, analyzed the literature on cardiovascular complications and mortality among patients with PA, studied the issues of total cardiovascular risk, presented the results of numerous clinical studies that allow PA to be considered a disease associated with increased the risk of cardiovascular complications. Considering the role of proinflammatory cytokines in the pathogenesis of psoriatic arthritis, early detection of endothelial lesions represents the most promising direction in the prevention of cardiovascular diseases, which are the main cause of mortality in this group of patients.
Ichthyosis is a skin disease that is hereditary, has pronounced symptoms in the form of a violation of the skin, and the presence of formations resembling fish scales. It is possible to distinguish different approaches to the definition of ichthyosis, based on the modern study of this issue. Ichthyosis is classified by type: congenital and acquired. Congenital ichthyosis has its own classification depending on the manifestation of changes in the skin, the course of the disease, concomitant pathologies. Congenital ichthyosis is divided into ordinary (vulgar autosomal dominant, simple) ichthyosis, lamellar ichthyosis (dry ichthyosiform erythroderma, "collodion child", lamellar ichthyosis), X-linked ichthyosis (ichthyosis associated with the X chromosome, blackening ichthyosis), congenital bullous ichthyosiform erythroderma (erythroderma Broca's disease, ichthyosiform epidermolytic hyperkeratosis), fetal ichthyosis (intrauterine ichthyosis, universal hyperkeratosis, "Harlequin fetus", congenital keratosis), other congenital ichthyosis. Ichthyosiform conditions (the so-called acquired ichthyosis) are divided into symptomatic, age-related (senile), discoid ichthyosis. The causes of acquired ichthyosis can be various diseases, taking medications, improper skin care, unbalanced nutrition. Each form of ichthyosis differs by the type of inheritance, prevalence in the population, clinical picture, verified by histological examination of skin biopsies and electron microscopic examination of the skin. It may be accompanied by seasonality of exacerbation of the clinical picture, association with other diseases (allergic, diseases of the gastrointestinal tract, congenital malformations). There is no specific treatment for ichthyosis. In systemic therapy, derivatives of vitamin A are used, keratolytics, as well as moisturizing and emollient agents are used for external treatment. The use of therapeutic baths, general ultraviolet irradiation is effective.
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