Case Report
Year: 2022 | Month: March | Volume: 9 | Issue: 3 | Pages: 222-227
DOI: https://doi.org/10.52403/ijrr.20220326
Diagnostic Challenges and Management of Patients with Overlapping Rheumatoid Arthritis with Psoriatic Arthritis: A Case Report
Carissa Ayu Zebadiah Rau1, Gede Kambayana2
1,2Department of Internal Medicine, Faculty of Medicine Udayana University, Sanglah General Hospital, Bali, Indonesia
Corresponding Author: Carissa Ayu Zebadiah Rau
ABSTRACT
Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) have key differences in clinical presentation, radiographic findings, and pathogenesis to distinguish between these common forms of chronic inflammatory arthritis. Several case reports report the occurrence of overlapping syndromes of RA with PsA. However, until now, the cases are still very rare.
We report A 33-year-old woman, complaining of pain in the joints of her fingers, toes, and her back since eight years ago. The patient also complained of red, silvery-white patches on the abdomen and spread all over the body. On the left hand, there is a swan neck deformity on the fifth finger of the left hand. On the right hand, there is a boutonniere deformity on the second and fourth fingers of the right hand and ulnar deviation of the first finger. On skin examination, it was found with multiple silvery-white erythematous plaques, varying in size, geographical shape, covered with fine white scales spread all over the body skin. The patient was diagnosed with Rheumatoid Arthritis based on the 2010 ACR/EULAR diagnostic criteria, overlapping with Psoriatic Arthritis syndrome based on the 2010 ASAS diagnostic criteria for spondyloarthropathy 2006 CASPAR for PsA.
The right diagnosis process speeds up the time for initiation of appropriate therapy to improve quality of life and improve disease prognosis.
Keywords: Rheumatoid arthritis, psoriatic arthritis, overlapping syndrome.
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