Psoriatic arthritis in children

As many as 12,000 children in the UK are affected by juvenile idiopathic arthritis (JIA).
There are three main types:
Systemic JIA (Still’s disease), (accounts for 20% of cases). Starts with a high fever, patchy red rash,enlarged lymph nodes, abdominal pain and weight loss.

Oligoarthritis, is the most common type of JIA accounting for 50% of new diagnoses in Europe each year. It is diagnosed when 4 or fewer joints are affected in the first 6 months of disease.

Polyarticular onset JIA, also known as polyarthritis accounts for 25% of new diagnoses and is diagnosed when 5 or more joints are affected in the first 6 months of disease. After 6 months from diagnosis, if 5 or more joints become affected it is then referred to as polyarticular-course JIA. Polyarthritis can be further divided into rheumatoid factor negative arthritis, and rheumatoid factor positive arthritis. Polyarthritis includes who are diagnosed with polyarticular JIA, but who then have more joints affected after 6 months also known as extended oligoarticular JIA.

Juvenile psoriatic arthritis (JPsA), accounts for 2 - 15% of new diagnoses and is diagnosed when there is joint pain association with psoriasis.

Juvenile psoriatic arthritis is sometimes thought of as part of the spectrum of juvenile chronic arthritis summarised above but others regard it as a separate disease to be distinguished from these, having more in common with reactive arthritis and juvenile ankylosing spondylitis.
The Vancouver criteria for diagnosis of psoriatic arthritis in childhood are a useful guide:

Definite psoriatic arthritis
o Arthritis with 3 of the 4 following minor criteria
o Dactylitis (pink swollen “sausage” finger or toe)
o Nail pitting or onycholysis (splitting and breaking up of nail)
o Psoriasis-like rash
o Family history of psoriasis in first or second degree relatives

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