الفهرس 
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Abstract
Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease affecting up to a third of psoriasis patients. PsA can affect different locations including the synovial joint, bone, fat pad, bursa, adjacent tendons, and enthuses. Enthesitis is a unique feature of the spondyloarthritis (SpA) disease group in general, and of PsA in particular Clinical enthesitis is a common finding occurring in PsA patients (Zabotti et al., 2016).
Enthesitis is characterised by pain and stiffness at tendon insertions, such as the Achilles tendon, the plantar fascia or the common extensor tendon insertion at the epicondyle of the elbow. Clinical assessment of enthesitis has been based traditionally by recognition of tenderness elicited by the palpation of the entheseal site (Mandl et al., 2015).
Most of the neutrophils in our blood are mature neutrophils. Immature neutrophils may be found on a blood smear if the body is stressed and there is a great need for more neutrophils. When this occurs, an increased number of immature neutrophils can make their way to the blood from the bone marrow before reaching maturity (Amulic et al., 2012).
We aimed to study the relation between immature neutrophils in blood and disease activity in psoriatic arthritis patients.
This is a randomized controled trial conducted at physical & Rheumatology outpatient clinic and Dermatology clinic of Ain shams university hospital and included 50 outpatients who are diagnosed as psoriatic arthritis by CASPAR criteria (Classification Criteria for psoriatic arthritis) and 20 healthy individual with matched age and sex.
All participants subjected to the following:
Full history talking,
General examination,
Local joint examination,
Clinical assessment of enthesopathy by (SPARCC), PASI and ASDAS index,
Laboratory investigation: Complete blood count searching for prescence of immature neutrophils, Blood Film with counting the immature neutrophils under microscobe and rheumatoid factor.
Our result shows the following:
• Comparison between the two groups showed that there was significant difference between them as regards immature neutrophils and WBCS while there was no significant difference between them regarding Absolute Neutrophils and Relative Neutrophils.
• The level of Immature Neutrophils statistically significantly increased as the activity of disease increased according to the ASDAS and PASI classification.
• The level of Immature Neutrophils statistically significantly increased in Axial PsA Patients, while it was statistically significantly decreased in Asymmetric PsA Patients