Anesthetic management of a patient with psoriasis arthropathica]

A 37-year-old woman with psoriasis arthropathica associated with aortic regurgitation underwent replacement of her aortic valve. The serum rheumatic factor was negative. HLA-B 27 was demonstrated in HLA analysis. She experienced a sudden onset of dyspnea and cardiac arrest in the hospital. She was hospitalized and found to have severe aortic regurgitation. She had her aortic valve replaced. We paid attention to management of blood pressure not to trigger cardiac ischemia and of skin lesion not to trigger infection and the worsening of skin condition. There are few reports of HLA-B 27 positive psoriasis arthropathica accompanied by aortic regurgitation. However, the present case may suggest that the cardiac study may be required for HLA-B 27 positive psoriasis arthropathica.