Psoriasis with Acro-Osteolysis

Buckley, William R.; Raleigh, Robert L.

doi:10.1056/nejm195909102611103

Cited by 27 publications

(8 citation statements)

References 3 publications

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“…This points towards tissue-specific factors rather than autoimmunity in general as being key drivers in the psoriatic onychopathy process. Given that Koebnerisation responses in the skin occur in the presence of tissue trauma or an aberrant repair response to it, then it is possible that much of the nail disease process is linked to joint mechanics and/or trauma 17 18. The genetic basis for these changes awaits elucidation.…”

Section: Discussionmentioning

confidence: 99%

Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails

et al. 2011

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“…Among these, articular trauma has been suspected as it is often followed by chronic arthritis. [1][2][3] In addition, infectious agents previously considered,13 have again been suggested more recently. '4 15 In this study, taking into account Moll's hypothesis,7 a wide range of environmental agents was considered.…”

Section: Discussionmentioning

confidence: 99%

Interplay between environmental factors, articular involvement, and HLA-B27 in patients with psoriatic arthritis.

Scarpa

Puente

Girolamo

et al. 1992

Annals of the Rheumatic Diseases

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“…Early studies by Moll and Wright reported an association between trauma and the subsequent evolution of PsA in the same digit, with digital trauma to interphalangeal joints being associated with subsequent arthritis mutilans at that site 51–53. This was termed as a ‘deep Koebner response’ and coined on the basis of the well-recognised Koebner response in psoriasis 54.…”

Section: The Role Of Trauma As a Specific Factor In The Early Phases mentioning

confidence: 99%

The early phase of psoriatic arthritis

McGonagle

Ash

Dickie

et al. 2011

Annals of the Rheumatic Diseases

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Evaluation of the preclinical phases of the classic autoimmune diseases including rheumatoid arthritis has been facilitated by the availability of autoantibody and genetic markers that point firmly towards the early dysregulation of the adaptive immune responses. The association of psoriatic disease with the human leucocyte antigen-Cw0602 (HLA-Cw0602) gene has likewise led to the perception that autoimmunity has a pivotal role in early psoriatic arthritis (PsA). However, this HLA-Cw0602 genetic association does not appear to hold for PsA or associated nail, scalp and intergluteal skin involvement. Of note, these three sites of psoriasis are predictive of PsA evolution. For initiation of both skin and nail disease there is a link with Koebnerisation, or site-specific trauma. Nail disease is most common in the dominant hand thumbnail, pointing towards local tissue factors as disease initiators Likewise, for PsA, there is also good evidence for a history of previous joint trauma and histological studies showing microdamage in normal entheses which are typical locations where PsA frequently occurs. Furthermore, subclinical enthesopathy including osteitis is common in subjects with psoriasis but without arthritis. Collectively, these findings indicate that the classic model of adaptive immune dysregulation does not generally hold for the early stages of PsA. The way in which knowledge pertaining to tissue-specific factors in PsA, combined with the emerging data relating to monogenic disorders and animal models, points towards perturbation in the healing response and dysregulation of innate immune responses in early PsA is discussed. The way in which this model explains the clinical disconnect between skin and joint disease and the emerging human data that support it are demonstrated.

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Psoriasis with Acro-Osteolysis

Cited by 27 publications

References 3 publications

Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails

Psoriasis patients with nail disease have a greater magnitude of underlying systemic subclinical enthesopathy than those with normal nails

Interplay between environmental factors, articular involvement, and HLA-B27 in patients with psoriatic arthritis.

The early phase of psoriatic arthritis

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