Dactylitis in psoriatic arthritis: clinical features, diagnosis, immunopathogenesis, and treatment

Abstract

When dactylitis is detected in a patient with psoriatic arthritis (PsA), it is necessary to use active treatment as soon as possible, since in the absence of therapy the disease progresses to joint erosion and functional disorders. The paper considers the clinical signs and diagnosis of PsA and notes the importance of differential diagnosis in this sign with other joint inflammatory diseases. It points to the necessity of elaborating common approaches to an objective assessment of the severity of dactylitis. Its immunopathogenesis and main treatment areas, including the use of biological agents (BAs), are detailed. There are data of clinical trials that have evaluated the efficiency of treatment for dactylitis and established that in most cases, the use of BAs considerably reduce not only the severity of its clinical signs, but also concomitant bone marrow edema. It is noted that the development of new pathogenetic treatments targeting a number of currently established biologically active molecules that play an important role in the pathogenesis of dactylitis will enhance the efficiency of treatment in patients with PsA.