Clinical case report: Unusual and severe psoriatic arthritis mutilans

Abstract

Psoriatic Arthritis (PsA) is considered part of the spondyloarthritis group, which is present in up to 42% of individuals with psoriasis and up to 15% of patients with psoriasis may have undiagnosed PsA. Psoriatic arthritis Mutilans is a rare but very aggressive type of advanced joint disease in patients with psoriasis. This report describes the case of a 67 years old patient with family history of psoriasis and undiagnosed psoriatic arthritis with nail lesions for more than 16 years, arthritis for 15 years and severe disease during the last 3 years with disability and bedridden. She had serious joint complications of the disease, as well as severe malnutrition. A missdiagnosis of rheumatoid arthritis was given during 15 years, HLAB27 was positive and radiography of hands and feet showed classic findings of psoriatic arthritis mutilans. We present this case to show the severity of the disease with rapid progression and multiple additional joint complications.