Clinical Rheumatology

, Volume 35, Issue 8, pp 1893–1901 | Cite as

Psoriatic arthritis and psoriasis: differential diagnosis

  • Maddalena Napolitano
  • Francesco Caso
  • Raffaele Scarpa
  • Matteo Megna
  • Angela Patrì
  • Nicola Balato
  • Luisa CostaEmail author
Review Article


Psoriasis frequency ranges from 1 to 3 % in white population, and arthritis occurs in 10–40 % of psoriasis patients, representing a relevant health issue. Psoriatic arthritis (PsA) is an inflammatory arthropathy, associated with psoriasis, in which ocular-, intestinal-, metabolic-, and cardiovascular-related manifestations can variably coexist. In order to favor early PsA and psoriasis diagnosis, it is crucial to rule out other conditions that can resemble the disease and delay appropriate therapeutic approach. Therefore, the aim of this review is to focus on PsA and psoriasis differential diagnosis.


Differential diagnosis Psoriatic arthritis Psoriasis 


Compliance with ethical standards




  1. 1.
    Moll JM, Wright V (1973) Psoriatic arthritis. Semin Arthritis Rheum 3:55–78PubMedCrossRefGoogle Scholar
  2. 2.
    Egeberg A, Khalid U, Gislason GH, Mallbris L, Skov L, Hansen PR (2015) Association of psoriatic disease with Uveitis: a Danish nationwide cohort study. JAMA Dermatol 151:1200–5PubMedCrossRefGoogle Scholar
  3. 3.
    Scarpa R, Manguso F, D’Arienzo A, D’Armiento FP, Astarita C, Mazzacca G, Ayala F (2000) Microscopic inflammatory changes in colon of patients with both active psoriasis and psoriatic arthritis without bowel symptoms. J Rheumatol 27:1241–6PubMedGoogle Scholar
  4. 4.
    Costa L, Caso F, D’Elia L, Atteno M, Peluso R, Del Puente A, Strazzullo P, Scarpa R (2012) Psoriatic arthritis is associated with increased arterial stiffness in the absence of known cardiovascular risk factors: a case control study. Clin Rheumatol 31:711–5PubMedCrossRefGoogle Scholar
  5. 5.
    Costa L, Caso F, Ramonda R, Del Puente A, Cantarini L, Darda MA et al (2015) Metabolic syndrome and its relationship with the achievement of minimal disease activity state in psoriatic arthritis patients: an observational study. Immunol Res 61:147–53PubMedCrossRefGoogle Scholar
  6. 6.
    Shen J, Shang Q, Li EK, Leung YY, Kun EW, Kwok LW, Li M, Li TK, Zhu TY, Yu CM, Tam LS (2015) Cumulative inflammatory burden is independently associated with increased arterial stiffness in patients with psoriatic arthritis: a prospective study. Arthritis Res Ther 17:75PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Caso F, Lubrano E, Del Puente A, Caso P, Peluso R, Foglia F, Benigno C, Girolimetto N, Bottiglieri P, Scarpa R, Costa L (2016) Progress in understanding and utilizing TNF-α inhibition for the treatment of psoriatic arthritis. Expert Rev Clin Immunol 12:315–31PubMedCrossRefGoogle Scholar
  8. 8.
    Goodman WA, Levine AD, Massari JV, Sugiyama H, McCormick TS, Cooper KD (2009) IL-6 signaling in psoriasis prevents immune suppression by regulatory T cells. J Immunol 183:3170–6PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    van Baarsen LG, Lebre MC, van der Coelen D, Aarrass S, Tang MW, Ramwadhdoebe TH, Gerlag DM, Tak PP (2014) Heterogeneous expression pattern of interleukin 17A (IL-17A), IL-17F and their receptors in synovium of rheumatoid arthritis, psoriatic arthritis and osteoarthritis: possible explanation for nonresponse to anti-IL-17 therapy? Arthritis Res Ther 16:426PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    van Kuijk AW, Reinders-Blankert P, Smeets TJ, Dijkmans BA, Tak PP (2006) Detailed analysis of the cell infiltrate and the expression of mediators of synovial inflammation and joint destruction in the synovium of patients with psoriatic arthritis: implications for treatment. Ann Rheum Dis 65:1551–7PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Fiocco U, Sfriso P, Oliviero F, Roux-Lombard P, Scagliori E, Cozzi L, Lunardi F, Calabrese F, Vezzù M, Dainese S, Molena B, Scanu A, Nardacchione R, Rubaltelli L, Dayer JM, Punzi L (2010) Synovial effusion and synovial fluid biomarkers in psoriatic arthritis to assess intraarticular tumor necrosis factor-α blockade in the knee joint. Arthritis Res Ther 12:R148PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Nestle FO, Turka LA, Nickoloff BJ (1994) Characterization of dermal dendritic cells in psoriasis. Autostimulation of T lymphocytes and induction of Th1 type cytokines. J Clin Invest 94:202–9PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Kirkham BW, Kavanaugh A, Reich K (2014) Interleukin-17A: a unique pathway in immune-mediated diseases: psoriasis, psoriatic arthritis and rheumatoid arthritis. Immunology 141:133–42PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Lynde CW, Poulin Y, Vender R, Bourcier M, Khalil S (2014) Interleukin 17A: toward a new understanding of psoriasis pathogenesis. J Am Acad Dermatol 71:141–50PubMedCrossRefGoogle Scholar
  15. 15.
    Isailovic N, Daigo K, Mantovani A, Selmi C (2015) Interleukin-17 and innate immunity in infections and chronic inflammation. J Autoimmun 60:1–11PubMedCrossRefGoogle Scholar
  16. 16.
    Fiocco U, Martini V, Accordi B, Caso F, Costa L, Oliviero F, Scanu A, Felicetti M, Frallonardo P, Facco M, Boso D, Molena B, Zambello R, Ramonda R, Cozzi F, Scarpa R, Basso G, Semenzato G, Dayer JM, Doria A, Punzi L (2015) Ex vivo signaling protein mapping in T lymphocytes in the psoriatic arthritis joints. J Rheumatol Suppl 93:48–52PubMedCrossRefGoogle Scholar
  17. 17.
    Fiocco U, Martini V, Accordi B, Caso F, Costa L, Oliviero F, Scanu A, Facco M, Boso D, Gatto M, Felicetti M, Frallonardo P, Ramonda R, Piva L, Zambello R, Agostini C, Scarpa R, Basso G, Semenzato G, Dayer JM, Punzi L, Doria A (2015) Transcriptional network profile on synovial fluid T cells in psoriatic arthritis. Clin Rheumatol 34:1571–80PubMedCrossRefGoogle Scholar
  18. 18.
    Fiocco U, Accordi B, Martini V, Oliviero F, Facco M, Cabrelle A, Piva L, Molena B, Caso F, Costa L, Scanu A, Pagnin E, Atteno M, Scarpa R, Basso G, Semenzato G, Punzi L, Doria A, Dayer JM (2014) JAK/STAT/PKCδ molecular pathways in synovial fluid T lymphocytes reflect the in vivo T helper-17 expansion in psoriatic arthritis. Immunol Res 58:61–9PubMedCrossRefGoogle Scholar
  19. 19.
    Perez-Aso M, Montesinos MC, Mediero A, Wilder T, Schafer PH, Cronstein B (2015) Apremilast, a novel phosphodiesterase 4 (PDE4) inhibitor, regulates inflammation through multiple cAMP downstream effectors. Arthritis Res Ther 17:249PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    McCann FE, Palfreeman AC, Andrews M, Perocheau DP, Inglis JJ, Schafer P, Feldmann M, Williams RO, Brennan FM (2010) Apremilast, a novel PDE4 inhibitor, inhibits spontaneous production of tumour necrosis factor-alpha from human rheumatoid synovial cells and ameliorates experimental arthritis. Arthritis Res Ther 12(3):R107PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Schafer PH, Parton A, Gandhi AK, Capone L, Adams M, Wu L, Bartlett JB, Loveland MA, Gilhar A, Cheung YF, Baillie GS, Houslay MD, Man HW, Muller GW, Stirling DI (2010) Apremilast, a cAMP phosphodiesterase-4 inhibitor, demonstrates anti-inflammatory activity in vitro and in a model of psoriasis. Br J Pharmacol 159:842–55PubMedCrossRefGoogle Scholar
  22. 22.
    O’Shea JJ, Schwartz DM, Villarino AV, Gadina M, McInnes IB, Laurence A (2015) The JAK-STAT pathway: impact on human disease and therapeutic intervention. Annu Rev Med 66:311–28PubMedCrossRefGoogle Scholar
  23. 23.
    Ogdie A, Weiss P (2015) The epidemiology of psoriatic arthritis. Rheum Dis Clin North Am 41:545–68PubMedCrossRefGoogle Scholar
  24. 24.
    Caso F, Costa L, Atteno M, Del Puente A, Cantarini L, Lubrano E, Scarpa R (2014) Simple clinical indicators for early psoriatic arthritis detection. Springerplus 3:759PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Marchesoni A, Atzeni F, Spadaro A, Lubrano E, Provenzano G, Cauli A et al (2012) Identification of the clinical features distinguishing psoriatic arthritis and fibromyalgia. J Rheumatol 39:849–55PubMedCrossRefGoogle Scholar
  26. 26.
    Gladman DD (2012) Early psoriatic arthritis. Rheum Dis Clin North Am 38:373–86PubMedCrossRefGoogle Scholar
  27. 27.
    Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H, CASPAR Study Group (2006) Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 54:2665–73PubMedCrossRefGoogle Scholar
  28. 28.
    Tillett W, Costa L, Jadon D, Wallis D, Cavill C, McHugh J, Korendowych E, McHugh N (2012) The ClASsification for psoriatic ARthritis (CASPAR) criteria—a retrospective feasibility, sensitivity, and specificity study. J Rheumatol 39:154–6PubMedCrossRefGoogle Scholar
  29. 29.
    Spadaro A, Lubrano E (2012) Psoriatic arthritis: imaging techniques. Reumatismo 64:99–106PubMedCrossRefGoogle Scholar
  30. 30.
    Ficjan A, Husic R, Gretler J, Lackner A, Graninger WB, Gutierrez M, Duftner C, Hermann J, Dejaco C (2014) Ultrasound composite scores for the assessment of inflammatory and structural pathologies in Psoriatic Arthritis (PsASon-Score). Arthritis Res Ther 16:476PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Fiocco U, Stramare R, Coran A, Grisan E, Scagliori E, Caso F, Costa L, Lunardi F, Oliviero F, Bianchi FC, Scanu A, Martini V, Boso D, Beltrame V, Vezzù M, Cozzi L, Scarpa R, Sacerdoti D, Punzi L, Doria A, Calabrese F, Rubaltelli L (2015) Vascular perfusion kinetics by contrast-enhanced ultrasound are related to synovial microvascularity in the joints of psoriatic arthritis. Clin Rheumatol 34:1903–12PubMedCrossRefGoogle Scholar
  32. 32.
    Soscia E, Sirignano C, Catalano O, Atteno M, Costa L, Caso F, Peluso R, Bruner V, Aquino MM, Del Puente A, Salvatore M, Scarpa R (2012) New developments in magnetic resonance imaging of the nail unit. J Rheumatol Suppl 89:49–53PubMedCrossRefGoogle Scholar
  33. 33.
    Tan AL, Fukuba E, Halliday NA, Tanner SF, Emery P, Mc Gonagle D (2015) High-resolution MRI assessment of dactylitis in psoriatic arthritis shows flexor tendon pulley and sheath-related enthesitis. Ann Rheum Dis 74:185–9PubMedCrossRefGoogle Scholar
  34. 34.
    Gutierrez M, Filippucci E, De Angelis R, Filosa G, Kane D, Grassi W (2010) A sonographic spectrum of psoriatic arthritis: “the five targets”. Clin Rheumatol 29:133–42PubMedCrossRefGoogle Scholar
  35. 35.
    Fiocco U, Sfriso P, Oliviero F, Lunardi F, Calabrese F, Scagliori E, Cozzi L, Di Maggio A, Nardacchione R, Molena B, Felicetti M, Gazzola K, Stramare R, Rubaltelli L, Accordi B, Costa L, Roux-Lombard P, Punzi L, Dayer JM (2013) Blockade of intra-articular TNF in peripheral spondyloarthritis: its relevance to clinical scores, quantitative imaging and synovial fluid and synovial tissue biomarkers. Joint Bone Spine 80:165–70PubMedCrossRefGoogle Scholar
  36. 36.
    Mandl P, Navarro-Compán V, Terslev L et al (2015) European league against rheumatism (EULAR). EULAR recommendations for the use of imaging in the diagnosis and management of spondyloarthritis in clinical practice. Ann Rheum Dis 74:1327–39PubMedCrossRefGoogle Scholar
  37. 37.
    Coates LC, Ritchlin CT, Kavanaugh AF (2014) GRAPPA treatment recommendations: an update from the GRAPPA 2013 Annual Meeting. J Rheumatol 41:1237–9PubMedCrossRefGoogle Scholar
  38. 38.
    Caso F, Costa L, Del Puente A, Scarpa R (2015) Psoriatic arthritis and TNF inhibitors: advances on effectiveness and toxicity. Expert Opin Biol Ther 15:1–2PubMedCrossRefGoogle Scholar
  39. 39.
    Dommasch ED, Abuabara K, Shin DB, Nguyen J, Troxel AB, Gelfand JM (2011) The risk of infection and malignancy with tumor necrosis factor antagonists in adults with psoriatic disease: a systematic review and meta-analysis of randomized controlled trials. J Am Acad Dermatol 64:1035–50PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Caso F, Cantarini L, Morisco F et al (2015) Current evidence in the field of the management with TNF-α inhibitors in psoriatic arthritis and concomitant hepatitis C virus infection. Expert Opin Biol Ther 15:641–50PubMedCrossRefGoogle Scholar
  41. 41.
    Atteno M, Costa L, Matarese A et al (2014) The use of TNF-α blockers in psoriatic arthritis patients with latent tuberculosis infection. Clin Rheumatol 33:543–7PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Costa L, Caso F, Atteno M et al (2014) Long-term safety of anti-TNF-α in PsA patients with concomitant HCV infection: a retrospective observational multicenter study on 15 patients. Clin Rheumatol 33:273–6PubMedCrossRefGoogle Scholar
  43. 43.
    Sanduzzi A, Bocchino M, Atteno M et al (2012) Screening and monitoring of latent tubercular infection in patients taking tumor necrosis factor-α blockers for psoriatic arthritis. J Rheumatol Suppl 89:82–5PubMedCrossRefGoogle Scholar
  44. 44.
    Scarpa R, Costa L, Atteno M, Del Puente A, Caso F, Moll JM (2013) Psoriatic arthritis: advances in pharmacotherapy based on molecular target. Expert Opin Pharmacother 14:2311–3PubMedCrossRefGoogle Scholar
  45. 45.
    Caso F, Del Puente A, Peluso R, Caso P, Girolimetto N, Del Puente A, Scarpa R, Costa L (2016) Emerging drugs for psoriatic arthritis. Expert Opin Emerg Drugs 21:69–79PubMedCrossRefGoogle Scholar
  46. 46.
    Atzeni F, Costa L, Caso F et al (2015) Role of agents other than tumor necrosis factor blockers in the treatment of psoriatic arthritis. J Rheumatol Suppl 93:79–81PubMedCrossRefGoogle Scholar
  47. 47.
    Picchianti-Diamanti A, Germano V, Ferlito C, Migliore A, D’Amelio R, Laganà B (2010) Health-related quality of life and disability in patients with rheumatoid, early rheumatoid and early psoriatic arthritis treated with etanercept. Qual Life Res 19:821–6PubMedCrossRefGoogle Scholar
  48. 48.
    McHugh NJ (2015) Early psoriatic arthritis. Rheum Dis Clin North Am 41:615–22PubMedCrossRefGoogle Scholar
  49. 49.
    Gladman DD (2015) Clinical features and diagnostic considerations in psoriatic arthritis. Rheum Dis Clin North Am 41:569–79PubMedCrossRefGoogle Scholar
  50. 50.
    Jones SM, Armas JB, Cohen MG, Lovell CR, Evison G, McHugh NJ (1994) Psoriatic arthritis: outcome of disease subsets and relationship of joint disease to nail and skin disease. Br J Rheumatol 33:834–9PubMedCrossRefGoogle Scholar
  51. 51.
    Scarpa R, Oriente P, Pucino A, Vignone L, Cosentini E, Minerva A, Biondi Oriente C (1988) The clinical spectrum of psoriatic spondylitis. Br J Rheumatol 27:133–7PubMedCrossRefGoogle Scholar
  52. 52.
    Gladman DD, Shuckett R, Russell ML, Thorne JC, Schachter RK (1987) Psoriatic arthritis (PSA)--an analysis of 220 patients. Q J Med 62:127–41PubMedGoogle Scholar
  53. 53.
    Scarpa R, Cosentini E, Manguso F, Oriente A, Peluso R, Atteno M, Ayala F, D’Arienzo A, Oriente P (2003) Clinical and genetic aspects of psoriatic arthritis “sine psoriasis”. J Rheumatol 30:2638–40PubMedGoogle Scholar
  54. 54.
    Gladman DD (2007) Axial disease in psoriatic arthritis. Curr Rheumatol Rep 9:455–60PubMedCrossRefGoogle Scholar
  55. 55.
    Höhler T, Märker-Hermann E (2001) Psoriatic arthritis: clinical aspects, genetics, and the role of T cells. Curr Opin Rheumatol 13:273–9PubMedCrossRefGoogle Scholar
  56. 56.
    Lubrano E, Parsons WJ, Marchesoni A, Olivieri I, D’Angelo S, Cauli A, Caso F, Costa L, Scarpa R, Brunese L (2015) The definition and measurement of axial psoriatic arthritis. J Rheumatol Suppl 93:40–2PubMedCrossRefGoogle Scholar
  57. 57.
    McEwen C, DiTata D, Lingg C, Porini A, Good A, Rankin T (1971) Ankylosing spondylitis and spondylitis accompanying ulcerative colitis, regional enteritis, psoriasis and Reiter’s disease. A comparative study. Arthritis Rheum 14:291–318PubMedCrossRefGoogle Scholar
  58. 58.
    Helliwell PS, Hickling P, Wright V (1998) Do the radiological changes of classic ankylosing spondylitis differ from the changes found in the spondylitis associated with inflammatory bowel disease, psoriasis, and reactive arthritis? Ann Rheum Dis 57:135–40PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Poggenborg RP, Østergaard M, Terslev L (2015) Imaging in psoriatic arthritis. Rheum Dis Clin North Am 41:593–613PubMedCrossRefGoogle Scholar
  60. 60.
    Kane D, Stafford L, Bresnihan B, FitzGerald O (2003) A classification study of clinical subsets in an inception cohort of early psoriatic peripheral arthritis--‘DIP or not DIP revisited’. Rheumatology (Oxford) 42:1469–76CrossRefGoogle Scholar
  61. 61.
    Jevtic V, Lingg G (2012) Differential diagnosis of rheumatoid and psoriatic arthritis at an early stage in the small hand and foot joints using magnetic resonance imaging. Handchir Mikrochir Plast Chir 44:163–70PubMedCrossRefGoogle Scholar
  62. 62.
    Balakrishnan C, Madnani N (2013) Diagnosis and management of psoriatic arthritis. Indian J Dermatol Venereol Leprol 79(Suppl 7):S18–24PubMedCrossRefGoogle Scholar
  63. 63.
    Olivieri I, D’Angelo S, Palazzi C, Padula A (2014) Advances in the management of psoriatic arthritis. Nat Rev Rheumatol 10:531–42PubMedCrossRefGoogle Scholar
  64. 64.
    Cervini C, Leardini G, Mathieu A, Punzi L, Scarpa R (2005) Psoriatic arthritis:epidemiological and clinical aspects in a cohort of 1.306 Italian patients. Reumatismo 57:283–90PubMedGoogle Scholar
  65. 65.
    Perez-Alamino R, Garcia-Valladares I, Cuchacovich R, Iglesias-Gamarra A, Espinoza LR (2014) Are anti-CCP antibodies in psoriatic arthritis patients a biomarker of erosive disease? Rheumatol Int 34:1211–6PubMedCrossRefGoogle Scholar
  66. 66.
    Del Puente A, Esposito A, Parisi A, Atteno M, Montalbano S, Vitiello M, Esposito C, Bertolini N, Foglia F, Costa L, Scarpa R (2012) Osteoporosis and psoriatic arthritis. J Rheumatol Suppl 89:36–8PubMedCrossRefGoogle Scholar
  67. 67.
    Del Puente A, Esposito A, Costa L, Benigno C, Del Puente A, Foglia F, Oriente A, Bottiglieri P, Caso F, Scarpa R (2015) Fragility fractures in patients with psoriatic arthritis. J Rheumatol Suppl 93:36–9PubMedCrossRefGoogle Scholar
  68. 68.
    Helliwell PS, Hetthen J, Sokoll K, Green M, Marchesoni A, Lubrano E, Veale D, Emery P (2000) Joint symmetry in early and late rheumatoid and psoriatic arthritis: comparison with a mathematical model. Arthritis Rheum 43:865–71PubMedCrossRefGoogle Scholar
  69. 69.
    Khan M, Schentag C, Gladman DD (2003) Clinical and radiological changes during psoriatic arthritis disease progression. J Rheumatol 30:1022–6PubMedGoogle Scholar
  70. 70.
    van Tubergen A, Weber U (2012) Diagnosis and classification in spondyloarthritis: identifying a chameleon. Nat Rev Rheumatol 8:253–61PubMedCrossRefGoogle Scholar
  71. 71.
    Colavite PM, Sartori A (2014) Septic arthritis: immunopathogenesis, experimental models and therapy. J Venom Anim Toxins Incl Trop Dis 20:19PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Scarpa R, Oriente P, Pucino A, Torella M, Vignone L, Riccio A, Biondi Oriente C (1984) Psoriatic arthritis in psoriatic patients. Br J Rheumatol 23:246–50PubMedCrossRefGoogle Scholar
  73. 73.
    Oriente P, Biondi-Oriente C, Scarpa R (1994) Psoriatic arthritis. Clin Manifestations Baillieres Clin Rheumatol 8:277–94PubMedCrossRefGoogle Scholar
  74. 74.
    CRAIN DC (1961) Interphalangeal osteoarthritis. JAMA 175:1049–53PubMedCrossRefGoogle Scholar
  75. 75.
    Peter JB, Pearson CM, Marmor L (1966) Erosive osteoarthritis of the hands. Arthritis Rheum 9:365–88PubMedCrossRefGoogle Scholar
  76. 76.
    Swezey RL, Alexander SJ (1971) Erosive osteoarthritis and the main en lorgnette deformity (opera glass hand). Arch Intern Med 128:269–72PubMedCrossRefGoogle Scholar
  77. 77.
    Smukler NM, Edeiken J, Giuliano VJ (1971) Ankylosis in osteoarthritis of the finger joints. Radiology 100:525–30PubMedCrossRefGoogle Scholar
  78. 78.
    McGonagle D, Hermann KG, Tan AL (2015) Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era. Rheumatology (Oxford) 54:29–38CrossRefGoogle Scholar
  79. 79.
    Haddad A, Johnson SR, Somaily M, Fazelzad R, Kron AT, Chau C, Chandran V (2015) Psoriatic arthritis mutilans: clinical and radiographic criteria. Syst Rev J Rheumatol 42:1432–8CrossRefGoogle Scholar
  80. 80.
    Jadon DR, Shaddick G, Tillett W, Korendowych E, Robinson G, Waldron N, Cavill C, McHugh NJ (2015) Psoriatic arthritis mutilans: characteristics and natural radiographic history. J Rheumatol 42:1169–76PubMedCrossRefGoogle Scholar
  81. 81.
    Gudbjornsson B, Ejstrup L, Gran JT, Iversen L, Lindqvist U, Paimela L, Ternowitz T, Ståhle M (2013) Psoriatic arthritis mutilans (PAM) in the Nordic countries: demographics and disease status. The Nordic PAM study. Scand J Rheumatol 42:373–8PubMedCrossRefGoogle Scholar
  82. 82.
    Napolitano M, Megna M, Monfrecola G (2015) Insulin resistance and skin diseases. ScientificWorldJournal 2015:479354PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Omland SH, Gniadecki R (2015) Psoriasis inversa: a separate identity or a variant of psoriasis vulgaris? Clin Dermatol 33:456–61PubMedCrossRefGoogle Scholar
  84. 84.
    Kim BY, Choi JW, Kim BR, Youn SW (2015) Histopathological findings are associated with the clinical types of psoriasis but not with the corresponding lesional psoriasis severity index. Ann Dermatol 27:26–31PubMedPubMedCentralCrossRefGoogle Scholar
  85. 85.
    Johnson MA, Armstrong AW (2013) Clinical and histologic diagnostic guidelines for psoriasis: a critical review. Clin Rev Allergy Immunol 44:166–72PubMedCrossRefGoogle Scholar
  86. 86.
    Karadag AS, Kavala M, Ozlu E, Ozkanlı S, Zindancı İ, Turkoglu Z (2016) Erythrodermic pityriasis rubra pilaris: dramatic response to Infliximab therapy. Indian J Dermatol Venereol Leprol 82:112PubMedCrossRefGoogle Scholar
  87. 87.
    Amann PM, Susic M, Glüder F, Berger H, Krapf W, Löffler H (2015) Alitretinoin (9-cis retinoic acid) is effective against pityriasis rubra pilaris: a retrospective clinical study. Acta Derm Venereol 95:329–31PubMedCrossRefGoogle Scholar
  88. 88.
    Yun CH, Kim JS, Ryu HR, Kim JH, Baek JO, Lee JR, Roh JY (2016) Circumscribed juvenile pityriasis rubra pilaris responsive to alitretinoin. Dermatol Ther 29:81–3PubMedCrossRefGoogle Scholar
  89. 89.
    Griffiths WA (1980) Pityriasis rubra pilaris. Clin Exp Dermatol 5:105–12PubMedCrossRefGoogle Scholar
  90. 90.
    Kalra MG, Higgins KE, Kinney BS (2014) Intertrigo and secondary skin infections. Am Fam Physician 89:569–73PubMedGoogle Scholar
  91. 91.
    Balato N, Di Costanzo L, Balato A (2009) Differential Diagnosis of Psoriasis. J Rheumatol. 36 Suppl 83.Google Scholar
  92. 92.
    Panda M, Patro N, Jena M, Dash M, Mishra S (2014) Pityriasis rosea like drug rash—a need to identify the disease in childhood. J Clin Diagn Res 8:YD01–2PubMedPubMedCentralGoogle Scholar
  93. 93.
    Guarneri F, Cannavò SP, Minciullo PL, Gangemi S (2015) Pityriasis rosea of Gibert: immunological aspects. J Eur Acad Dermatol Venereol 29:21–5PubMedCrossRefGoogle Scholar
  94. 94.
    James W, Berger T, Elston D (2005) Andrews’ diseases of the skin: clinical dermatology (10th ed). Saunders. pp. 208–9.Google Scholar
  95. 95.
    Clark GW, Pope SM, Jaboori KA (2015) Diagnosis and treatment of seborrheic dermatitis. Am Fam Physician 91:185–90PubMedGoogle Scholar
  96. 96.
    Hay RJ (2011) Malassezia, dandruff and seborrhoeic dermatitis: an overview. Br J Dermatol 165(Suppl 2):2–8PubMedCrossRefGoogle Scholar
  97. 97.
    Dessinioti C, Katsambas A (2013) Seborrheic dermatitis: etiology, risk factors, and treatments: facts and controversies. Clin Dermatol 31:343–51PubMedCrossRefGoogle Scholar
  98. 98.
    Zegpi MS, Ruiz FM, Porras NK (2015) Pityriasis lichenoides: case report and review of the literature. Rev Chil Pediatr 86:121–5PubMedCrossRefGoogle Scholar
  99. 99.
    Errichetti E, Lacarrubba F, Micali G, Piccirillo A, Stinco G (2015) Differentiation of pityriasis lichenoides chronica from guttate psoriasis by dermoscopy. Clin Exp Dermatol 40:804–6PubMedCrossRefGoogle Scholar
  100. 100.
    Brazzelli V, Carugno A, Rivetti N, Cananzi R, Barruscotti S, Borroni G (2013) Narrowband UVB phototherapy for pediatric generalized pityriasis lichenoides. Photodermatol Photoimmunol Photomed 29:330–3PubMedCrossRefGoogle Scholar
  101. 101.
    Park JM, Jwa SW, Song M, Kim HS, Chin HW, Ko HC, Kim MB, Kim BS (2013) Is narrowband ultraviolet B monotherapy effective in the treatment of pityriasis lichenoides? Int J Dermatol 52:1013–8PubMedCrossRefGoogle Scholar
  102. 102.
    Someshwar S, Udare S (2012) Pityriasis lichenoides. Indian Pediatr 49:936–7PubMedCrossRefGoogle Scholar
  103. 103.
    Benhamou CL, Chamot AM, Kahn MF (1988) Synovitis-acne-pustulosis hyperostosis-osteomyelitis syndrome (SAPHO). A new syndrome among the spondyloarthropathies? Clin Exp Rheumatol 6:109–12PubMedGoogle Scholar
  104. 104.
    Caso F, Rigante D, Vitale A, Lucherini OM, Costa L, Atteno M, Compagnone A, Caso P, Frediani B, Galeazzi M, Punzi L, Cantarini L (2013) Monogenic autoinflammatory syndromes: state of the art on genetic, clinical, and therapeutic issues. Int J Rheumatol 2013:513782PubMedPubMedCentralCrossRefGoogle Scholar
  105. 105.
    Chamot AM, Benhamou CL, Kahn MF, Beraneck L, Kaplan G, Prost A (1987) Acne-pustulosis-hyperostosis-osteitis syndrome. Results of a national survey. 85 cases. Rev Rhum Mal Osteoartic 54:187–96PubMedGoogle Scholar
  106. 106.
    Sidoroff A, Halevy S, Bavinck JN, Vaillant L, Roujeau JC (2001) Acute generalized exanthematous pustulosis (AGEP)--a clinical reaction pattern. J Cutan Pathol 28:113–9PubMedCrossRefGoogle Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2016

Authors and Affiliations

  • Maddalena Napolitano
    • 1
  • Francesco Caso
    • 2
  • Raffaele Scarpa
    • 2
  • Matteo Megna
    • 1
  • Angela Patrì
    • 1
  • Nicola Balato
    • 1
  • Luisa Costa
    • 2
    Email author
  1. 1.Dermatology Unit, Department of Clinical Medicine and SurgeryUniversity Federico IINaplesItaly
  2. 2.Rheumatology Unit, Department of Clinical Medicine and SurgeryUniversity Federico IINaplesItaly

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