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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mrj</journal-id><journal-title-group><journal-title xml:lang="ru">Современная ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Modern Rheumatology Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1996-7012</issn><issn pub-type="epub">2310-158X</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/1996-7012-2018-1-5-12</article-id><article-id custom-type="elpub" pub-id-type="custom">mrj-802</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЛЕКЦИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LECTURES</subject></subj-group></article-categories><title-group><article-title>Дактилит при псориатическом артрите : особенности клинических проявлений, диагностика, иммунопатогенез и лечение</article-title><trans-title-group xml:lang="en"><trans-title>Dactylitis in psoriatic arthritis: clinical features, diagnosis, immunopathogenesis, and treatment</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коротаева</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Korotaeva</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><email xlink:type="simple">tatianakorotaeva@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Логинова</surname><given-names>Е. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Loginova</surname><given-names>E. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A. Nasonova Research Institute of Rheumatology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>02</day><month>04</month><year>2018</year></pub-date><volume>12</volume><issue>1</issue><fpage>5</fpage><lpage>12</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Коротаева Т.В., Логинова Е.Ю., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Коротаева Т.В., Логинова Е.Ю.</copyright-holder><copyright-holder xml:lang="en">Korotaeva T.V., Loginova E.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://mrj.ima-press.net/mrj/article/view/802">https://mrj.ima-press.net/mrj/article/view/802</self-uri><abstract><p>При обнаружении дактилита у больного псориатическим артритом (ПсА) необходимо как можно раньше назначить активное лечение, поскольку в отсутствие терапии наблюдается  прогрессирование заболевания вплоть до эрозирования суставов и развития функциональных нарушений. В статье рассмотрены клинические признаки и  диагностика ПсА, отмечена важность дифференциальной диагностики по этому признаку с  другими воспалительными заболеваниями суставов. Указана необходимость выработки  единых подходов к объективной оценке тяжести дактилита. Подробно описаны  иммунопатогенез и основные направления его лечения, в том числе с использованием  генно-инженерных биологических препаратов (ГИБП). Приведены данные клинических  исследований, в которых оценивалась эффективность лечения дактилита и установлено, что использование ГИБП в большинстве случаев способствует существенному уменьшению не  только выраженности его клинических признаков, но и сопутствующего отека костного  мозга. Отмечено, что разработка новых патогенетических методов лечения, таргетных в отношении ряда установленных к настоящему времени биологически активных молекул,  которые играют важную роль в патогенезе дактилита, будет способствовать повышению  эффективности лечения больных ПсА.</p></abstract><trans-abstract xml:lang="en"><p>When dactylitis is detected in a patient with psoriatic arthritis (PsA), it is necessary to use active treatment as soon as possible, since in the absence of therapy the disease progresses to joint erosion and  functional disorders. The paper considers the clinical signs and  diagnosis of PsA and notes the importance of differential diagnosis in this sign with other joint inflammatory diseases. It points to the  necessity of elaborating common approaches to an objective  assessment of the severity of dactylitis. Its immunopathogenesis and main treatment areas, including the use of biological agents (BAs),  are detailed. There are data of clinical trials that have evaluated the  efficiency of treatment for dactylitis and established that in most  cases, the use of BAs considerably reduce not only the severity of its clinical signs, but also concomitant bone marrow edema. It is noted  that the development of new pathogenetic treatments targeting a number of currently established biologically active molecules that  play an important role in the pathogenesis of dactylitis will enhance  the efficiency of treatment in patients with PsA.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>псориатический артрит</kwd><kwd>дактилит</kwd><kwd>энтезит</kwd><kwd>генно-инженерные биологические препараты</kwd><kwd>иммунопатогенез</kwd></kwd-group><kwd-group xml:lang="en"><kwd>psoriatic arthritis</kwd><kwd>dactylitis</kwd><kwd>enthesitis</kwd><kwd>biological agents</kwd><kwd>immunopathogenesis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Mease P, Gladman D, Helliwell P, et al. Comparative performance of psoriatic arthritis screening tools in patients with psoriasis in Europen/North American dermatology clinics. 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