Abstract
Impairment of capillaries permeability and changes of microcirculation are associated with inflammatory arthritis. In order to demonstrate microvascular differences between psoriatic arthritis (PsA) and rheumatoid arthritis (RA) we analyzed capillaroscopic abnormalities such as megacapillaries, haemorrhages, ramifications, and avascular areas in patients affected by these two rheumatic disorders. Moreover to identify specific capillaroscopy patterns we analyzed the following parameters: venous limb diameter, arterial limb diameter, capillary loop diameter, amplitude of the capillary loop, linear density of capillaries (on 2 mm), and number of twisted capillaries (on 4 mm). Through a comparative morphometric analysis of capillaroscopy, our study demonstrated the presence of specific microvascular differences between PsA and RA providing an additional diagnostic tool for the differential diagnosis. We also suggest that capillaries structural abnormalities might reflect endothelial injury due to systemic inflammation during chronic arthritis.
Highlights
Psoriatic arthritis (PsA) is a chronic inflammatory disease affecting 0.04%–0.1% of the general population and occurs in one-third of patients with psoriasis
Presence of citrullinated peptide antibodies has a high specificity for rheumatoid arthritis (RA), but, among that, they are rarely seen in PsA patients [5]
From January 2012 to March 2013, 30 patients affected by PsA, 30 patients affected by RA, 30 patients affected by Psoriasis (Pso) without signs of arthropathy, and 30 healthy subjects as control, attending the Rheumatology Department of the University of Rome “Tor Vergata” and the Dermatology Department of San Gallicano Dermatologica Institute, were enrolled
Summary
Psoriatic arthritis (PsA) is a chronic inflammatory disease affecting 0.04%–0.1% of the general population and occurs in one-third of patients with psoriasis. PsA can lead to severe bone erosions and joints destruction resulting in physical disability [1]. No specific laboratory tests are available for PsA; it is not always possible, confirm the diagnosis and provide an objective prognosis, especially at an early stage of disease. The differential diagnosis between PsA and RA is very difficult in PsA patients with slight cutaneous signs and rheumatoid-like joint involvement [2,3,4]. Presence of citrullinated peptide antibodies has a high specificity for RA, but, among that, they are rarely seen in PsA patients [5]. Morphological and rheological changes in microcirculation have been widely demonstrated in PsA and RA patients
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