11/18/2023 0 Comments Weird websites from 10 years ago![]() The computerized axial tomography of the sacroiliac joints showed fusion of the lower 2/3 and sclerosis of the upper 1/3 ( Fig. With these new findings, imaging studies were performed, finding in the radiography of the hands diffuse osteopenia of the right carpal bones with narrowing of the proximal interphalangeal joint spaces of the 5th finger bilaterally and of the 3rd finger of the right hand with minimal soft tissue edema, in the cervical spine X-ray there was fusion of the facet joints C7 to T1 and, in the feet, metacarpophalangeal subluxation of all fingers and valgus deformity ( Fig. A PASI (psoriasis area and severity index) of 48 was calculated. A skin biopsy was performed which showed parakeratosis and intracorneal pustules ( Fig. On some nails there was onycholysis, subungual hyperkeratosis and oil drop sign ( Fig. On the scalp there were plaques with adherent desquamation, type false tinea amiantacea, extending beyond the anterior hair implantation edge. The physical examination showed circumscribed erythematous plaques, with raised edges and thick desquamation which compromised the entire body surface ( Figs. In addition, the patient had 2 previous hospitalizations, 6 years earlier, due to acute diarrheal disease managed as intestinal amebiasis. His joint pains had been previously studied (negative rheumatoid factor in 4.6 IU/mL, C3 in 232 mg/dL, normal C4 in 13.3 mg/dL, ANA 1/40 with fine speckled pattern, HLA-B27 was not taken) and had been managed as rheumatoid arthritis with prednisolone and chloroquine without improvement of the clinical picture. The pain was disabling, and for this reason he had been in bed for 7 months and managed it with nonsteroidal anti-inflammatory drugs without improvement. On the interrogation, the patient reported low back pain of 8 years of evolution, predominantly in the morning, which over the years had spread to the knees and ankles, with preference for the left side, associated with edema, and to the cervical region and metatarsophalanges. During the hospitalization, the patient was assessed by the dermatology service due to a clinical picture of 8 months of evolution of generalized asymptomatic skin lesions. Clinical caseĪ 35-year-old male patient hospitalized due to bleeding of the lower digestive tract, secondary to cholestatic jaundice due to ascaris. This is the case of a patient with an unusual presentation of psoriatic arthritis associated with psoriasis ostracea, after 10 years of management with infliximab. 2 Psoriasis ostracea is an infrequent variant of psoriasis which has been reported very few times in the literature. 2 It occurs in 20–30% of patients with psoriasis and the symptoms usually begin after the skin lesions. 2,3 Psoriatic arthritis is an inflammatory chronic seronegative arthropathy, with a world prevalence of 0.16–0.25%. 1 It is a chronic inflammatory, immune mediated condition that leads to epidermal hyperplasia with a wide variety of clinical forms, being plaque psoriasis the most frequent. Psoriasis is a common cutaneous disease, it is estimated that its worldwide prevalence ranges between 0.9 and 8.5%. It has become an important space in the work of all rheumatologists from Central and South America. It is intended for rheumatologists, general internists, specialists in related areas, and general practitioners in the country and abroad. It is an academic tool for the different members of the academic and scientific community at their different levels of training, from undergraduate to post-doctoral degrees, managing to integrate all actors inter-and transdisciplinarily. It covers an extensive area of topics ranging from the broad spectrum of the clinical aspects of rheumatology and related areas in autoimmunity (both in pediatric and adult pathologies), to aspects of basic sciences. Since its foundation, the Journal has been characterized by its plurality with subjects of all rheumatic and osteomuscular pathologies, in the form of original articles, historical articles, economic evaluations, and articles of reflection and education in Medicine. It was created in December 1993 with the purpose of disseminating scientific information derived from primary and secondary research and presenting cases coming from the practice of Rheumatology in Latin America. The Colombian Journal of Rheumatology (Revista Colombiana de Reumatología) is the official organ of the Colombian Association of Rheumatology (Asociación Colombiana de Reumatología) and the Central American, Caribbean and Andean Association of Rheumatology (Asociación Centroamericana Caribe Andina de Reumatología) - ACCAR.
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