Study Objective: to present literature review of clinical parameters and course of psoriatic arthritis (PsA) in children, and results of PsA patients examination in University Clinical Children Hospital of I.M. Sechenov First Moscow State Medical University. Study Design: open prospective study. Materials and Methods. We analysed medical records of 83 children with PsA aged 3 to 17 years who were examined and managed in University Clinical Children Hospital of I.M. Sechenov First Moscow State Medical University in 1989 – 2019. Study Results. Confirmed PsA was diagnosed in 59 (71%) children, suspected PsA — in 24 (29%) children; 44 (53%) children got ill before they were 6.5 years old. In 24 (29%) patients, disease started with skin involvement; in 59 (71%) patients, articular syndrome was the first manifestation of disease. In the group of patients with confirmed psoriasis, the most common was plaque psoriasis: it was diagnosed in 45 (76.3%) out of 59 children; guttate psoriasis was found in 8 (13.5%) children, isolated nail plaque psoriasis — in 3 (5.1%) patients, and palm and foot psoriasis — in 3 (5.1%) children. Psoriasis of the scalp was diagnosed in 23 (39%) subjects. In 8 (13.5%) patients, skin syndrome was associated with mild infiltration and scant desquamation. 18 (21.7%) out of 83 children had skin involvement together with nail bed involvement. Psoriasic onychodystrophy was diagnosed in 19 (23%) children (onycholysis, “oil patches” on fingers and toes); 15 (18.1%) children had “thimble syndrome”. On disease onset, 68.7% of children had oligoarticular, sometimes asymmetric articular syndrome; 18.1% had symmetric rheumatoid-like disease, 13.2% — psoriasic spondylitis. After 5 years of follow-up, articular syndrome transformed: 41.2% of patients had symmetric rheumatoid-like disease, 24.1% — asymmetric oligoarthritis, 24.1% — spondylarthritis with peripheral joint involvement, and 10.8% — arthritis mutilans. Most commonly PsA affected knee, talocrural joints, small hand joints – 41%, 31.3%, 29%, respectively. Conclusion. Clinical manifestations of PsA varied a lot. Our patients did not have a second peak. Almost one third of children had skin changes prior to arthritis development. Onset of disease was associated with asymmetric oligoarthritis prevalence. Later, articular syndrome changed, and symmetric rheumatoid-like disease prevailed. Keywords: children, psoriatic arthritis, psoriasis, juvenile idiopathic arthritis, Vancouver diagnostic criteria.

Rheumatoid uveitis is a serious problem in rheumatology and ophthalmology due to the peculiarities of the disease – an undistinguished beginning, chronic course and a high incidence of disabling complications. The article analyzes various data on the development and nature of uveitis in children with juvenile idiopathic arthritis. The authors describe the analysis of the results of various studies of this disease. They consider the features and results of treatment of children with rheumatoid uveitis using genetically engineered biological drugs.

Background. Inflammatory bowel diseases, which include Crohn's disease and ulcerative colitis, are immune-mediated inflammatory diseases with a complex pathogenesis. In addition to the involvement of the intestinal wall in the pathological process, systemic extraintestinal manifestations are observed in Crohn's disease and ulcerative colitis, and there is also often an association with psoriasis and psoriatic arthritis. Objective. Purpose of the study was to analyze the nature of the articular syndrome in children with inflammatory bowel diseases associated with juvenile psoriatic arthritis. Materials and methods. A retrospective analysis of the nature of the articular syndrome was carried out in a group of children with inflammatory bowel diseases associated with juvenile psoriatic arthritis (20 patients, mean age 12.7 years (95% CI [11.01; 14.29]). The diagnosis of juvenile psoriatic arthritis was established according to the Vancouver diagnostic criteria (1989). The diagnosis of Crohn's disease was established in accordance with Clinical recommendations for Crohn's disease for pediatric patients, 2025. The diagnosis of ulcerative colitis was established in accordance with Clinical guidelines for ulcerative colitis for pediatric patients, 2025. Statistical processing was performed using parametric methods and exact formulas for percentages. Results. 17/20 (85%) of our patients were diagnosed with Crohn's disease, inflammatory form, 3/20 patients (15%) – ulcerative colitis. The diagnosis of definite juvenile psoriatic arthritis, according to the Vancouver diagnostic criteria, was made in 11/20 patients (55%), probable – in 9/20 (45%). Boys predominated in the group – 14/20 (70%). The mean disease duration was 5.0 years (95% CI [3.21, 6.79] years). 13/20 (65%) patients had relatives 1 and 2 degrees of relatives suffered from psoriasis. All children with definite psoriatic arthritis (11/20 children) had plaque (vulgar) psoriasis. In 15/20 (75%) patients, the onset of articular syndrome was asymmetrical oligoarthritis. At the height of the disease, the oligoarticular variant was observed in 10/20 (50%) children, rheumatoid-like (polyarticular) in 3/20 (15%), spondyloarthritis with damage to peripheral joints in 7/20 (35%). The most commonly affected joints were the knee (15/20 (75%)), ankle (5/20 (25%)), and hip (8/20 (40%)) joints. Conclusions. The articular syndrome in inflammatory bowel diseases associated with juvenile psoriatic arthritis is characterized by a frequent onset of the disease with joint damage (in 40%), asymmetric oligoarthritis at the onset and at the height of the disease, while isolated juvenile psoriatic arthritis is characterized by a pattern of development of the articular syndrome from oligo- to polyarthritis. The association of inflammatory bowel diseases and juvenile psoriatic arthritis is characterized by a high percentage of spondyloarthritis with damage to peripheral joints (35%). The most common joints involved are the knee and hip joints (75% and 40%), with a high incidence of enthesitis (55%), while in isolated juvenile psoriatic arthritis the knee and ankle joints are most often affected. The course of inflammatory bowel diseases against the background of psoriatic arthritis requires an individual approach to patient management and selection of therapy aimed at the common links in the pathogenesis of these conditions.

Systemic juvenile idiopathic arthritis (SJIA) accounts for 10–15% of juvenile arthritis cases. The incidence of inflammatory bowel disease (IBD) is generally higher in SJIA patients than in the general pediatric population; however, the association of IBD with SJIA is rare. Among 65 patients with SJIA managed in two pediatric rheumatology centers, IBD was detected in 3 patients 3, 8, and 10 years from the SJIA onset. The clinical presentation of IBD in patients with SJIA is rather scanty; the diagnosis is mainly based on the colonoscopy and biopsy results. In 2 patients, Crohn's disease was diagnosed, and undifferentiated colitis in 1 patient.

Introduction. A range of diseases that require differential diagnostic search in persistent joint syndrome in children include juvenile idiopathic arthritis (JIA) and joint lesions in inflammatory bowel diseases (IBD). Aim . To analyze and compare the nature of joint syndrome in children with JIA and Crohn’s disease (CD) with joint lesions. Materials and methods . The joint syndrome was analyzed in a group that included 23 children with JIA and 24 children with Crohn’s disease with joint lesions. Statistical data were processed using parametric tests and exact formulas for percentage-based relationships. Results . JIA typically affected the knee, ankle, hip, and wrist joints (21 (91.3%), 14 (60.9%), 15 (65.2%), and 5 (21.7%) children, respectively). Enthesopathies were detected in 4 (17.4%) children. CD caused spondyloarthritis in 5 children (10.8%) and peripheral joint lesions in 15 patients (58.3%). Knees, hips, and small joints of the hands and feet were affected most frequently (14 (58.3%), 13 (54.2%), 9 (37.5%), and 4 (16.7%) children, respectively). Enthesopathies were detected in 10 children (41.7%). An analysis of the comparative frequency of joint lesions in JIA and CD showed that the knee, ankle, and wrist joints were significantly more often involved in JIA, while enthesitis were significantly more often detected in CD (p < 0.05). 5 patients (10.8%) had CD-associated spondyloarthritis. Antinuclear antibodies were identified significantly more often in patients with JIA (p < 0.05). The article is also illustrated with two clinical case reports. Conclusions . The data presented demonstrate differences in the nature of joint syndrome in children with JIA and CD. A detailed history taking, physical examination, and assessment of the nature of the joint syndrome make it possible to establish a correct diagnosis and select a rational approach to the management of patients.