Rheumatic manifestations of psoriasis

Area of Science:

• Rheumatology
• Dermatology
• Radiology

Background:

• Psoriatic arthritis (PsA) is a distinct rheumatic disease, often grouped with spondyloarthropathies.
• Recent recognition of rheumatic manifestations like enthesopathy and osteoperiostitis in psoriasis patients.

Purpose of the Study:

• To investigate rheumatological and radiological manifestations of psoriasis.
• To assess the association between these manifestations and skin/nail disease severity.

Main Methods:

• Consecutive interviews of 81 psoriatic outpatients over 6 months.
• Utilized questionnaires and indices for skin, nail, and rheumatic disease assessment.
• Performed radiological examinations of hands, feet, spine, and pelvis.

Main Results:

• 73% of patients exhibited clinical and/or radiological psoriatic arthropathy (PsA).
• Common findings included sacroiliitis/spondylitis (64.4%), enthesopathy (61%), and osteoperiostitis (83%).
• Subungual hyperkeratosis strongly correlated with PsA and its various manifestations.

Conclusions:

• Psoriatic arthropathy is more prevalent than previously assumed, affecting a majority of psoriasis outpatients.
• Existing diagnostic criteria for PsA demonstrate poor performance, lacking both sensitivity and specificity.
• Development of enhanced diagnostic and classification criteria for PsA is crucial, incorporating recent clinical and radiological findings.