Quality of life and its relation to periarticular bone changes in psoriatic patients with or without joint...

To assess periarticular bone changes in psoriasis patients with or without joint involvement and its effect on patients' quality of life (QoL).

This cross-sectional study enrolled 50 patients with psoriasis (25 only with skin psoriasis (PsO) and 25 with psoriatic arthritis (PsA)), as well as 25 healthy controls. All participants were analyzed by high-resolution computed tomography (HR-CT) scans of the dominant hand (second and third metacarpophalangeal joints) for detection of new bone formation (enthesophytes) and erosions. Demographic, laboratory, clinical, and disease-specific data, including physical function and QoL, were collected.

Physical function and QoL scores were significantly worse in the PsA patients than in the PsO patients. All 25 PsA patients (100%), 18 PsO patients (72%), and 5 healthy individuals (20%) had periarticular bone changes. Statistically significant higher erosion number and volume as well as higher enthesophyte number and height were found in PsA patients compared to both PsO patients and controls, and in PsO patients compared to controls. In PsO patients, the number of erosions and enthesophytes had a negative correlation with some Short Form (SF)-36 sub-scores. In the PsA patients, the number of erosions had a positive correlation with psoriasis disability index, while the number of enthesophytes had a negative correlation with the general health SF-36 sub-score.

In PsO patients, there may be subclinical periarticular inflammation (erosions and enthesophytes) that raise the suspicion of occult PsA or the possibility of PsO transition to PsA and these periarticular bone changes may worsen QoL in PsO patients. Key Points • Skin psoriasis patients may have subclinical PsA. • Periarticular bone changes in PsO patients may be the early sign for uploading PsA disease. • Quality of life is highly affected in PsA than in PsO patients.