head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing
ISSN: 1312-773X (Online)
Issue: 2018, vol. 24, issue2
Subject Area: Medicine
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DOI: 10.5272/jimab.2018242.1972
Published online: 03 April 2018

Case reports

J of IMAB. 2018 Apr-Jun;24(2):1972-1977
PSORIASIS, PSORIATIC ARTHRITIS AND SECONDARY GOUT – 3 CASE REPORTS
Mina IvanovaORCID logo Corresponding Autoremail, Rositsa KaralilovaORCID logo, Zguro BatalovORCID logo,
Departement of Rheumatology, Faculty of Medicine, UMHAT Kaspela, Medical University - Plovdiv, Bulgaria.

ABSTRACT:
Background: One of the most common complications in psoriasis is the development of secondary gout that often remains undiagnosed for many years. In some cases, the clinical symptoms of gout precede the manifestation of cutaneous psoriasis, leading to progression of the disease and early onset of complications. According to the world data, there is a strong correlation between psoriasis vulgaris and psoriatic arthritis on the one hand and gout on the other ranging from 3 to 40%. In Bulgaria, there are no studies observing the frequency of secondary gout in psoriatic patients.
Purpose: We present 3 patients with psoriatic arthritis first misdiagnosed like gout.
Results: Due to the diagnostic mistake, the disease is active despite the optimal urate-lowering therapy. When initiating the underlying antirheumatic therapy for psoriatic arthritis, patient’s attacks and the number of tophi starts to decrease and uric acid levels remain stable in reference values.
Conclusion: These three case reports reveal the difficult differentiation of the types of arthritis and the importance of correct diagnosis in order to optimize the therapy and reduce the risk of developing complications that leads to increased mortality of the patients.

Keywords: Psoriasis, Psoriatic arthritis, Secondary gout,

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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Ivanova M, Karalilova R, Batalov Z. Psoriasis, psoriatic arthritis and secondary gout – 3 case reports. J of IMAB. 2018 Apr-Jun;24(2):1972-1977. DOI: 10.5272/jimab.2018242.1972

Corresponding AutorCorrespondence to: Mina Ilieva Ivanova, UMHAT ,,Kaspela”, Medical University – Plovdiv; 64, Sofia str., Plovdiv, Bulgaria; E-mail: mina_87@abv.bg,

REFERENCES:
1. Gladman DD, Anhorn KA, Schachter RK, Mervart. HLA antigens in psoriatic arthritis. J Rheumatol. 1986; Jun;13(3):586-92. [PubMed]
2. Reich K, Kruger K, Mossner R, Augustin M. Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol. 2009;160(5):1040–7. [PubMed] [CrossRef]
3. Danielsen K, Olsen AO, Wilsgaard T, Furberg A. Is the prevalence of psoriasis increasing? A 30-year fol- low-up of a population–based cohort. Br J Dermatol. 2013;168(6):1303-10.  [PubMed] [CrossRef]
4.Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol. 2014;70(3):512-6. [PubMed] [CrossRef]
5. Falodun O. Characteristics of patients with psoriasis seen at the dermatology clinic of a tertiary hospital in Nigeria: a 4-year review 2008–2012. J Eur Acad Dermatol Venereol. 2013 Jul;27:43-43.
6. Liu JT, Yeh HM, Liu SY, Chen KT. Psoriatic arthritis: Epidemiology, diagnosis, and treatment. World J Orthop. 2014 Sep 18;5(4):537-43. [PubMed] [CrossRef]
7. Eisen AZ, Seegmiller JE. Uric acid metabolism in psoriasis. J Clin Invest. 1961 Aug;40(8 Pt 1-2):1486-94. [CrossRef]
8. Batalov А. [Musculoskeletal Ultrasonography in contemporary Rheumatology] 3rd edit. Plovdiv: LaxBook; 2013. 279  [In Bulgarian]
9. Batalov A, Anastasov A, Kuzmanova S, Tzvetkova T. [Ulatrsonogpraphy of the knee joint for detection of intra articular tophi in gout]. Revmatologia. 1998;4:52-56.[In Bulgarian]
10. Karalilova R, Ivanova M, Dzambazova S, Batalov Z, Petrova R. [Crystal- induced arthropathy – characteristic, clinical signs, diagnostic methods]. MEDICAL Magazine. 2016; XXVII(04):48-54. [In Bulgarian]
11. Ivanova M, Hristova R, Jeliazkova M, Karalilova M, Marinkov A, Batalov A. [Psоriasis vulgaris, psoriatic arthritis and risk of secondary gout]. MEDICAL Magazine. 2016; XXVII(04):60-62. [In Bulgarian]
12. Heilrmann F. [Uric acid examinations in psoriasis]. Arch. f. Dermat. u. Syph. 1930; (161):114, [In German]
13. Steinberg AG, William Becker S, Fitzpatrick TB, Kierland RR. A genetic and statistical study of psoriasis. Am J Hum Genet. 1951 Sep;3(3):267-81.
14. Lea WA Jr, Curtis AC, Bernstein IA. Serum uric acid levels in psoriasis. J Invest. Dermat. 1958 Nov;31(5):269-71. [PubMed]
15. Baumann RR, Jillson OF. Hyperuricemia and psoriasis. J Invest Dermatol. 1961;36:105-7. [PubMed]
16. Tickner A, Mier D. Serum cholesterol, uric acid and proteins in psoriasis. Br J Dermatol. 1960 Apr;72:132-7. [PubMed]
17. Bruce I, Schentag C, GladmanD. Hyperuricemia in psoriatic arthritis: prevalence and associated features. J Clin Rheumatol. 2000 Feb;6(1):6-9. [PubMed]
18. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med.2004 Mar 11;350(11):1093-103. [PubMed] [CrossRef]
19. Kwon HH, Kwon IH, Choi JW, Youn JI. Cross-sectional study on the correlation of serum uric acid with disease severity in Korean patients with psoriasis. Clin Exp Dermatol.2011 Jul;36(5):473-8. [PubMed] [CrossRef]
20. Lopez-Reyes A; Hernandez-Dнaz C; Hofmann F; Pineda C. Gout mimicking psoriatic arthritis flare. J Clin Rheumatol. 2012 Jun;18(4):220. [PubMed] [CrossRef]
21. Gisondi P, Tessari G, Conti A, Piaserico S,Giannetti A, Girolomoni G, et al. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case–control study. Br J Dermatol. 2007 Jul;157(1):68-73. [PubMed] [CrossRef]
22. AshishkumarA, Habibunnisha B,Sirajwala H. A study of serum uric acid levels in patients with psoriasis. Int J Res Med. 2013;2(3):13-16.
23. Merola JF; Wu S; Han J; Choi HK; Qureshi AA. Psoriasis, psoriatic arthritis and risk of gout in US men and women. Ann Rheum Dis. 2015 Aug;74(8):1495-500. [PubMed] [CrossRef].

Received: 24 January 2018
Published online: 03 April 2018

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