El papel del dermatólogo en el diagnóstico precoz de la artritis psoriásica: recomendaciones de un grupo de expertos

Abstract

Resumen La artritis psoriásica (APs) es una forma común de artritis inflamatoria que aparece hasta en el 40% de los pacientes con psoriasis. Dado que la afectación cutánea suele preceder a la afectación articular, los dermatólogos desempeñan un papel fundamental en la detección precoz de la APs. El diagnóstico precoz es importante para reducir el riesgo de daños estructurales irreversibles, limitar el deterioro de la función física y mejorar la calidad de vida de los pacientes. El presente documento ha sido elaborado por un grupo de especialistas (nueve dermatólogos y un reumatólogo) con el objetivo de proporcionar recomendaciones sencillas que ayuden a los dermatólogos en el cribado de la APs en pacientes con psoriasis. Los expertos elaboraron el presente documento ofreciendo unas recomendaciones consensuadas basadas en una revisión descriptiva de la evidencia científica disponible y en la experiencia adquirida en la práctica clínica diaria.

A multidisciplinary team for the diagnosis and management of psoriatic arthritis

“…Notably, telemedicine is of great significance in the multidisciplinary management of psoriasis, especially in the current situation of COVID-19 epidemic. [ 2 ]…”

“…However, the sensitivity and specificity of current screening methods of PsA remain relatively low. [ 2 ] Dermatology and rheumatology departments in China have begun to jointly participate in the online cooperation, aiming to find suitable screening tools for the early diagnosis of PsA. Early arthritis for psoriatic patients (EARP) is a simple and user-friendly screening tool, which is more sensitive than that of PASE and PEST.…”

“…Therefore, RF seropositivity in patients with characteristic manifestations of PsA cannot directly rule out the diagnosis of PsA. [ 2 ] Experts suggested that before referring patients to rheumatologists for faster diagnosis, dermatologists need to test the following blood biomarkers: RF, CRP, and human leukocyte antigen B27 in patients with axial pain. [ 2 ] In recent years, the successful application of interleukin-17 (IL-17) antagonists in PsA treatment suggested that IL-17 may be one of the effective biomarkers of PsA.…”

“…[ 2 ] Experts suggested that before referring patients to rheumatologists for faster diagnosis, dermatologists need to test the following blood biomarkers: RF, CRP, and human leukocyte antigen B27 in patients with axial pain. [ 2 ] In recent years, the successful application of interleukin-17 (IL-17) antagonists in PsA treatment suggested that IL-17 may be one of the effective biomarkers of PsA. [ 2 ] It is reported that serum chemokine C-X-C ligand 10 (CXCL10) level significantly increases in psoriasis patients who have progressed to PsA and its level in the synovial fluid of PsA patients elevates 44.3 times compared with that of gout patients.…”

“…[ 2 ] In recent years, the successful application of interleukin-17 (IL-17) antagonists in PsA treatment suggested that IL-17 may be one of the effective biomarkers of PsA. [ 2 ] It is reported that serum chemokine C-X-C ligand 10 (CXCL10) level significantly increases in psoriasis patients who have progressed to PsA and its level in the synovial fluid of PsA patients elevates 44.3 times compared with that of gout patients. [ 6 ] Therefore, CXCL10 may be a potential diagnostic marker for PsA.…”