PSORIASIS, PSORIATIC ARTHRITIS AND SECONDARY GOUT – 3 CASE REPORTS

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