Patients with PsA are at increased risk of cardiovascular morbidities compared with the general population. In addition to known risk factors for CVD, severe psoriasis is an important predictor in patients with PsA.

Background: Fatigue is an important symptom in psoriatic arthritis (PsA). Aim: To determine the reliability and validity of the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT fatigue) Scale in PsA. Methods: Consecutive patients attending the PsA clinic were assessed with the FACIT fatigue Scale twice, 1 week apart. Patients were assessed clinically according to a standardised PsA clinic protocol. Internal consistency of the 13 items on the FACIT fatigue questionnaire was measured using Cronbach's a; test-retest reliability by the intraclass correlation coefficient (ICC), and validity by the correlation of the FACIT fatigue results with other fatigue measures and disease characteristics. Conclusion:The FACIT fatigue results were reproducible, and correlated with other fatigue measures as well as with disease activity in patients with PsA. Therefore, the FACIT fatigue is a reliable and valid instrument to measure fatigue in PsA.

Aim: To describe dactylitis in a large cohort of patients with psoriatic arthritis followed prospectively in a specialist clinic, and identify whether it is associated with a worse prognosis. Methods: Between 1979 and 1999, 537 patients were registered in the psoriatic arthritis clinic and entered onto a longitudinal database. Patients were followed prospectively at six to 12 month intervals according to a standard protocol, and all information was entered onto a database. The database was searched for patients with dactylitis. Descriptive statistics were used to describe the population and x 2 tests to relate dactylitis to radiographic changes. Results: Dactylitis was documented in 260 patients (48%); 69% of the episodes were recorded at presentation to the clinic. Dactylitis affected feet only in 65% of cases, hands only in 24%, and both hands and feet in 12%. Recurrent dactylitis occurred in 44% of the patients. Increased radiological progression was noted in digits showing dactylitis compared with those without dactylitis (50% v 38%, respectively; p,0.0001). Conclusions: Dactylitis is common among patients with psoriatic arthritis. It most often affects the feet, in an asymmetrical distribution. It is associated with a greater degree of radiological damage than occurs in digits not affected by dactylitis. P soriatic arthritis is an inflammatory arthritis associated with psoriasis.

Our simplified index is very good at classifying those who are not diagnosed with PsA and those who are diagnosed with PsA.