Psoriatic arthritis: A permanent new challenge for dermatologists (Review)

Abstract

Considering that most of the patients (>2/3) are diagnosed with psoriasis in the cutaneous form long before the joint damage occurs and, in these conditions, a significant proportion of them is found in the dermatologist's initial records, a question must be asked: when is it necessary to send these patients to a rheumatology consultation? The recognition of psoriatic arthritis in patients with vulgar psoriasis and the dermatologist's ability to differentiate it from other arthritis, offers the opportunity to improve patient prognosis by prompt intervention and close collaboration with the rheumatologist. Diagnosis of early psoriatic arthropathy should be considered when a patient with psoriasis or family history of psoriasis has peripheral inflammatory arthritis (oligoarthritis or distal interphalangeal joints damage), enthesitis, dactylitis, spinal pain of inflammatory type. Given that patients with psoriasis are included in the dermatologists' medical records, it is very important to recognize psoriatic arthritis in patients with cutaneous psoriasis, to differentiate it from other possible arthritis, thus having the possibility to improve patient prognosis by prompt intervention and through collaboration with the rheumatologist.

Efficacy of secukinumab and adalimumab in patients with psoriatic arthritis and concomitant moderate‐to‐severe plaque psoriasis: results from EXCEED, a randomized, double‐blind head‐to‐head monotherapy study

“…Furthermore, it is estimated that PsA in approximately 10–15% of patients with psoriasis remains undiagnosed or misdiagnosed 19 . Hence, it is vital to routinely screen patients with psoriasis for the diagnosis of PsA in a dermatology clinic 20 . Delay of PsA diagnosis can lead to irreversible joint damage, even if a significant improvement in psoriasis occurs 5 .…”

“… 19 Hence, it is vital to routinely screen patients with psoriasis for the diagnosis of PsA in a dermatology clinic. 20 Delay of PsA diagnosis can lead to irreversible joint damage, even if a significant improvement in psoriasis occurs. 5 Therefore, dermatologists have a pivotal role in early identification of patients with PsA and prevention of irreversible joint damage.…”

Psoriasis beyond the skin: Ophthalmological changes (Review)

“…This is a bilateral condition and the symptoms include red, painful eyes with pericorneal congestion, reduction or even loss of visual acuity and photophobia may also occur (1,6,12,19). Previous studies have demonstrated the association between uveitis and different types of psoriasis, but uveitis is more frequent among patients with HLA B27-positive psoriatic arthritis (20); however, the association is not fully understood. Uveitis may also develop in patients with pustular psoriasis (5,12).…”

Prevalence and Characteristics of Psoriasis in Romania—First Study in Overall Population

“…A total of 20-30% of patients with psoriasis also develop psoriatic arthritis, which over time leads to severe, deforming joint injuries, which often cause disability [5]. In the absence of a set of specific criteria for the diagnosis of psoriatic arthritis, the most commonly used method for recognizing and monitoring this condition remains the clinical aspect [6].…”