Clifford Anekeover 6 years ago

Psoriatic Arthritic Mutilans

An interesting case of a 51 year old male patient diagnosed with psoriatic arthritis at the age of 18. For the last 20 years he refused treatment abandoned any follow-up and was unseen by any health care professional. . The disease progressed to a so called arthritis mutilans which is the most severe and destructive form of psoriatic arthritis. In arthritis mutilans, a patient's fingers become shortened by arthritis, and the shortening may become severe enough that the hand looks paw-like, with the first deformity occurring at the interphalangeal and metacarpophalangeal joints. The excess skin from the shortening of the phalanx bones becomes folded transversely, as if retracted into one another like opera glasses, hence the description la main en lorgnette. As the condition worsens, luxation, phalangeal and metacarpal bone absorption, and skeletal architecture loss in the fingers occurs. . Today, with early diagnosis and easy access to disease modifying antirheumatic drugs, such severe deformities are extremely rare.