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Related to arthritis mutilans: psoriatic arthritis
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Nail involvement occurred most often in those with the DIP predominant (100%) and arthritis mutilans (100%) subtypes of PsA while it was the least common in the symmetrical polyarthritis (50%) and spondylitis (62.
Psoriatic arthritis patient distribution according to the Moll and Wright criteria n % Types Spondylitis 23 46 DIP joint involvement 2 4 Asymmetrical oligoarthritis 28 56 Symmetrical polyarthritis 8 16 Arthritis mutilans 2 4 Isolated and overlapped subtypes Isolated spondylitis 10 20 DIP joint involvement 2 4 Asymmetrical oligoarthritis 15 30 Symmetrical polyarthritis 8 16 Arthritis mutilans 1 2 Spondylitis + asymmetrical oligoarthritis 12 24 Spondylitis + arthritis mutilans 1 2 Asymmetrical oligoarthritis + arthritis mutilans 1 2 Total 50 100 DIP: Distal interphalangeal.
Some patients suffer minor symptoms, while others may develop severe deformities, such as arthritis mutilans, a destructive arthritis of the interphalangeal joints that presents with swollen shortened fingers (called "sausage digits" due to their appearance).
Table 2 Moll and Wright Classification for Psoriatic Arthritis I Classic PsA confined to DIP II Symmetric polyarthritis similar to RA III Asymmetric oligoarthritis with dactylitis IV Ankylosing spondylitis with or without peripheral joint involvement V Arthritis mutilans
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