Psoriatic Arthritis: An Assessment of Clinical; Biochemical and Radiological Features in a Single-Centre South African Cohort

BACKGROUND:Although psoriatic arthritis (PsA) is a well-documented clinical entity; epidemiological; clinical and radiological studies of South African (SA) patients are scarce.OBJECTIVES:To assess clinical; biochemical and radiological features in a single-centre SA cohort.METHODS: We conducted a prospective assessment of the clinical; biochemical and radiological features of 384 consecutive patients with PsA seen at the rheumatology clinic at Prince Mshiyeni Memorial Hospital; Durban; SA; between January 2007 and December 2013. Patients were assessed at enrolment and 6 months after enrolment. They were classified into five groups as described by Moll and Wright; being entered into the group that best described the clinical manifestations. Clinicopathological characteristics recorded at enrolment were age at the time of examination; racial background; personal and family medical history; age and symptoms at the onset of PsA; pattern of joint involvement; joint pain; and the relationship between joint pain and the onset of PsA.RESULTS:Of the patients; 59.1% had a polyarticular presentation indistinguishable from rheumatoid arthritis; 19.0% had distal interphalangeal involvement; 9.1% had spondyloarthropathy; 11.9% had oligoarthritis and 0.9% had arthritis mutilans. The epidemiological trends (male/female ratio 1.45:1; mean age at onset of arthritis 50.2 (standard deviation 11.8) years; female preponderance in the polyarticular group and male preponderance in the spondyloarthropathy and oligoarticular groups) were similar to trends published elsewhere. A notable characteristic of our cohort was the complete absence of black South Africans with PsA.CONCLUSIONS:The complete absence of black South Africans with PsA is interesting. We anticipate that our findings will prompt genetic studies to isolate both protective and susceptibility genes for further elucidating PsA

Odontogenic keratocyst in Jamaica: a review of five new cases and five instances of recurrence together with comparative analyses of four treatment modalities / Queratoquiste odontogénico en jamaica: revisión de cinco casos nuevos y cinco casos reincidentes acompañados de análisis comparativos de cuatro modalidades de tratamiento

AIM: Five new cases of odontogenic keratocyst (OKC) together with five instances of recurrence are reviewed with special emphasis on radiology and surgical management. A comparative analysis offour different treatment modalities used in the treatment of OKC in these patients (new and recurrent cases) is reported. SUBJECTS AND METHODS: The case notes and radiographs ofpatients who had histological confirmation of OKC at both the Cornwall Regional Hospital and Kingston Public Hospital in Jamaica were reviewed for demographics, radiological presentation, treatment modalities and outcome of treatment. Cases of recurrence were separated from new cases. This study was conducted for the period 1980 to 2004. RESULTS: Five new cases and five instances of recurrence were documented over the 25-year period The new cases of OKC keratocyst accounted for 1.71of the total jaw bone tumours and 12of OKC keratocysts over the first 16 years. The posterior mandible appears to be the most favoured site. Of significance, one case of nevoid basal cell carcinoma syndrome (NBCCS) and a case of ameloblastomatous transformation in the wall of an OKC keratocyst were recorded The age range of the new cases was 12 to 44 years. CONCLUSION: The radiological finding from this review is similar to previous reports. However the authors record a unique and historic case of ameloblastomatous transformation of OKC. A case of OKC in NBCCS is also documented Of all four surgical treatment modalities compared, only cryosurgery was promising, so far with no recurrence after a follow-up period of six years.

Objetivo: Se examinan cinco casos nuevos de queratoquiste odontogénico (QQO) junto con cinco casos reincidentes, con énfasis especial en el tratamiento radiológico y quirúrgico. Se reporta un análisis comparativo de las cuatro diferentes modalidades de tratamiento usadas en el tratamiento del QQO en estos pacientes (los casos nuevos y los casos reincidentes). Sujetos y métodos: A fin de conocer la demografía, la presentación radiológica, las modalidades de tratamiento y los resultados del tratamiento, se examinaron las radiografías y las notas de los casos que tuvieron confirmación histológica de QQO, tanto en el Cornwall Regional Hospital como en el Kingston Public Hospital de Jamaica. Los casos de reincidencia fueron separados de los casos nuevos. Este estudio abarcó el periodo comprendido de.1980 a 2004. Resultados: Cinco nuevos casos y cinco casos reincidentes fueron documentados en ese período de 25 años. Los nuevos casos de QQO dieron cuenta del 1.71% del total de tumores de mandíbula y del 12% de los queratoquistes odontogénicos en los primeros 16 años. La mandíbula posterior parece ser el sitio más favorecido. De significación particular fue la documentación de un caso de síndrome de carcinoma basal celular nevoide (SCCBN), y un caso de transformación ameloblastomatosa en la pared de un queratoquiste odontogénico. El rango de la edad de los nuevos casos fue de 12 a 44 años. Conclusión: El hallazgo radiológico de este estudio, es similar al de reportes previos. Sin embargo, los autores documentan un caso único e histórico de transformación ameloblastomatosa del QQO. También se documenta un caso de QQO en SCCBN. De las cuatro modalidades de tratamiento comparadas, sólo la criocirugía ha sido promisoria hasta el momento, por cuanto no presentó reincidencias luego de un período de seguimiento de seis años.