Indonesian Elderly With Psoriatic Arthritis And Scleroderma: A Case Report
Abstract
Introduction: Psoriatic arthritis and scleroderma co-occurring was an uncommon case.
Case presentation: An Indonesian woman, 70 years old, complained of pain and stiffness in the right knee and ankle joints. This pain and stiffness reduce as the patient moves or stretches. Meanwhile, she has a history of type 2 diabetes mellitus (T2DM) and has been taking Sitagliptin 100 mg once daily for 10 years. In physical examination, she presented an abnormality in the right knee and ankle joint, with deformity and stiffness in several joints. Additional examination showed that the classification criteria for psoriatic arthritis (CASPAR) score was 3, the disease activity for psoriatic arthritis (DAPSA) score was 20 (moderate), and the modified Rodnan skin score (mRss) was 20 (severe). Then, she has a random blood glucose of 166 mg/dL, GD2PP 209 mg/dL, and HbA1c 8.3%. The immunoserology revealed a solid positive for antigen Scl-70, indicating positive autoantibody in systemic scleroderma. The patient received Myfortic 2×360 mg/day, Methylprednisolone 4 mg once daily, Folic acid 1 mg once daily, Nifedipine 5 mg thrice daily, Sitagliptin 100 mg once daily, and Natrium diclofenac 50 mg twice daily (for pain appearance). She was followed for 6 months and showed improvement after undergoing treatment.
Conclusion: The prognosis of psoriatic arthritis is influenced by early diagnosis, the number of affected joints, and bone inflammation. Meanwhile, the prognosis of scleroderma depends on the symptoms that appear. Therefore, both psoriatic arthritis and scleroderma require comprehensive management, including early diagnosis and treatment of complications to improve quality of life.
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