A 58-year-old man with refractory psoriatic uveitis was successfully treated with infliximab therapy. The patient was diagnosed with chronic plaque psoriasis at the age of 25 years; he then developed non-granulomatous anterior uveitis, which manifested as nephelopsia, at the age of 33 years. He was treated with cyclosporin and topical corticosteroids, but the treatment was not sufficiently effective. At the age of 58 years, he developed pustular psoriasis and had a high risk of blindness attributable to recurrent uveitis and glaucoma caused by treatment with topical corticosteroids. Six weeks after infliximab was administered, both the skin eruptions and the uveitis improved rapidly and remarkably. We investigated the clinical characteristics of psoriatic uveitis in 4 of our cases and in 27 other cases reported in Japan. In most of these cases, psoriatic uveitis initially manifested as visual impairment and was followed in sequence by nephelopsia, conjunctival hyperemia, and ophthalmalgia. Of the psoriatic patients, 92% and 96% had articular symptoms and the HLA-A2 allele, respectively. In 90% of the patients, skin manifestations of psoriatic uveitis were observed prior to the ocular symptoms, which developed much later. The findings suggest that psoriatic uveitis is related to both the articular symptoms and the HLA-A2 allele.
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