Psoriatic Arthritis: Pathogenesis and Clinical findings In tendons and connective tissues: • Enthesitis - Pain/tenderness over ligament insertion into bone • Dactylitis - Inflammation of entire digit- soft tissue and joints are inflamed In skin: • Psoriatic plaques on skin, pitting, ridging, oil spots, onycholysis, discoloration and hyperkeratosis In Joints: 1. Asymmetric oligoarthritis 2. Arthritis of DIP joints 3. Symmetric polyarthritis (like RA) 4. Axial involvement (unknown reason, probably due to "biomechanical", "innervation" & "vascularity") 5. Arthritis mutilans (aggressive & destructive) • X-ray: Periostitis; syndesmophytes, erosions, pencil in cup deformities due to osteolysis (IP joints), ankylosois of IP joints #PsoriaticArthritis #pathophysiology #diagnosis #signs #symptoms

Serotonin-Norepinephrine Reuptake Inhibitors(SNRIs): Mechanisms and Side Effects Withdrawal: Dizziness, Diarrhea, Insomnia, Nausea, Vomiting Serotonin Syndrome - Potentially Life Threatening: - Autonomic Hyperactivity: Hypertension, Tachycardia, Dilated pupils - Neuromuscular Abnormalities: Ocular Clonus, Tremor, Hyperreflexia, Muscle clonus - Cognitive Changes: Agitation, Akathisia Incr 5-HT: Anorexia, Insomnia, Fatigue, Vertigo, Sexual Dysfunction, Weight gain Incr NE: Nausea, Diaphoresis, Constipation, Dry Mouth #SNRIs #SerotoninNorepinephrine #Inhibitors #Pathophysiology #Pharmacology #SideEffects #Psychiatry #Diagnosis #Signs #Symptoms

Genital Skin Ulcers - Differential Diagnosis Algorithm Painful: • Herpes simplex • Haemophilus ducreyi (chancroid) • Behcet's syndrome • Pemphigus vulgaris • Lichen sclerosis • Erosive lichen planus Painless: • Primary syphilis (chancre) • Granuloma inguinale • Lymphogranuloma venereum #painless #genitals #Ulcers #ulcerative #skinrash #dermatology #Differential #Diagnosis #Algorithm #causes