Cutaneous manifestations of spondyloarthritis

Abstract

Spondyloarthritis comprises a group of inflammatory rheumatic disorders with a genetic predisposition involving multiple genes that interact with environmental factors. The skin manifestations of spondyloarthritis are diverse, particularly psoriatic arthritis related to the overexpression of inflammatory cytokines such as TNF, IL-6, IL-12, IL-2 and IFN-g; this psoriatic dermatitis is a common skin feature of spondyloarthritis. Spondyloarthritis mainly affects the spine, sacroiliac joints, ligaments and other tissues. Psoriatic lesions are erythematous plaques covered with silvery whitish scales distributed on the scalp, elbows, knees, trunk and gluteus creases, and the fingernails are frequently involved. Individuals with reactive arthritis and Crohn’s disease may exhibit psoriasiform dermatitis and other manifestations including ocular inflammation, oral ulceration, erythema nodosum and/or thrombophlebitis. In the case of reactive arthritis, male patients may exhibit circinate balanitis and keratoderma blennorrhagica. In summary, dermatological manifestations of spondyloarthritis represent clinical clues and a unique scenario to explore the related pathophysiology and therapeutic approaches.