Psoriatic Arthritis: What the Dermatologist Needs to Know, Part 1

López-Ferrer, A.; Torrente-Segarr, V.; Puig, L.

doi:10.1016/S1578-2190(10)70680-6

Article information

Abstract

Psoriatic arthritis is defined as inflammatory arthritis occurring in patients with psoriasis and is classified as a seronegative spondyloarthropathy associated with human leukocyte antigen B27. Between 25% and 35% of patients with psoriasis go on to develop psoriatic arthritis during the course of their disease. Given that the skin is affected before the joints in most cases, the dermatologist must be able to recognize the signs and symptoms in order to make a diagnosis and start the most appropriate treatment. This review aims to cover key aspects of the initial diagnostic workup and clinical evaluation. It examines the epidemiology, pathogenesis, and manifestations of psoriatic arthritis, as well as the complementary tests and diagnostic tools the dermatologist should be aware of in order to make the correct diagnosis.

Keywords:

Psoriasis

Psoriatic arthritis

Epidemiology

Pathogenesis

Resumen

La artritis psoriásica (APso) se define como la artritis inflamatoria asociada a la psoriasis y se clasifica dentro de las espondiloartropatías seronegativas asociadas a HLA-B27. Se estima que entre el 25 y el 35% de los pacientes con psoriasis pueden desarrollar una artritis psoriásica a lo largo de la enfermedad. Dado que en la mayoría de los casos la afectación cutánea precede a la articular, es de gran importancia que el dermatólogo sepa reconocer los signos y síntomas de esta para iniciar el proceso diagnóstico y establecer el tratamiento más adecuado para el paciente. En esta revisión se pretende abarcar los aspectos necesarios para abordar el diagnóstico y evaluación inicial de la artritis psoriásica e incluye aspectos relacionados con la epidemiología, patogenia y clínica de la APso, así como las pruebas complementarias y encuestas diagnósticas que el dermatólogo debe conocer para establecer un diagnóstico correcto.

Palabras clave:

Psoriasis

Artritis psoriásica

Epidemiología

Patogenia

Full text is only aviable in PDF

References

[1.]

D.D. Gladman.

Psoriatic arthritis.

Dermatol Ther, 22 (2009), pp. 40-55

http://dx.doi.org/10.1111/j.1529-8019.2008.01215.x | Medline

[2.]

P.J. Mease.

Psoriatic arthritis update.

Bull NYU Hosp Jt Dis, 64 (2006), pp. 25-31

Medline

[3.]

S.L. Taylor, M. Petrie, K.S. O’Rourke, S.R. Feldman.

Rheumatologists’ recommendations on what to do in the dermatology office to evaluate and manage psoriasis patients’ joint symptoms.

J Dermatol Treatment, 20 (2009), pp. 1-4

[4.]

K.E. Nograles, R.D. Brasington, A.M. Bowcock.

New insights into the pathogenesis and genetics of psoriatic arthritis.

Nat Clin Pract Rheumatol, 5 (2009), pp. 83-86

http://dx.doi.org/10.1038/ncprheum0987 | Medline

[5.]

K.C. Duffin, V. Chandran, D.D. Gladman, G.G. Krueger, J.T. Elder, P. Rahmann.

Genetics of psoriasis and psoriatic artritis: update and future direction.

J Rheumatol, 35 (2008), pp. 1449-1453

Medline

[6.]

Y. Liu, C. Helms, W. Liao, L.C. Zaba, S. Duan, J. Gardner, et al.

A genome-wide association study of psoriasis and psoriatic arthritis identifies new disease loci.

PLoS Genet, 4 (2008), pp. e1000041

http://dx.doi.org/10.1371/journal.pgen.1000041 | Medline

[7.]

D.H. Ciocon, A.B. Kimball.

Psoriasis and psoriatic arthritis: separate or one and the same?.

Br J Dermatol, 157 (2007), pp. 850-860

http://dx.doi.org/10.1111/j.1365-2133.2007.08148.x | Medline

[8.]

D. McGonagle, A.L. Tan, M. Benjamin.

The nail as a musculoskeletal appendage - implications for an improved understanding of the link between psoriasis and arthritis.

Dermatology, 218 (2009), pp. 97-102

http://dx.doi.org/10.1159/000182250 | Medline

[9.]

C. Gabay, I.B. McInnes.

The biological and clinical importance of the ‘new generation’ cytokines in rheumatic diseases.

Arthritis Res Ther, 11 (2009), pp. 230

http://dx.doi.org/10.1186/ar2680 | Medline

[10.]

V. Wright, J.M. Moll.

Psoriatic arthritis. In seronegative polyarthritis.

North Holland Publising Co., (1976),

[11.]

P.J. Healy, P.S. Helliwell.

Measuring clinical enthesitis in psoriatic arthritis: assessment of existing measures and development of an instrument specific to psoriatic arthritis.

Arthritis Rheum, 59 (2008), pp. 686-691

http://dx.doi.org/10.1002/art.23568 | Medline

[12.]

A.A. Qureshi, P. Dominguez, K.C. Duffin, D.D. Gladman, P. Helliwell, P.J. Mease, et al.

Psoriatic arthritis screening tools.

J Rheumatol, 35 (2008), pp. 1423-1425

Medline

[13.]

M.E. Husni, K.H. Meyer, D.S. Cohen, E. Mody, A.A. Qureshi.

The PASE questionnaire: Pilot-testing a psoriatic arthritis screening and evaluation tool.

J Am Acad Dermatol, 57 (2007), pp. 581-587

http://dx.doi.org/10.1016/j.jaad.2007.04.001 | Medline

[14.]

D.D. Gladman, C.T. Schentag, B.D.M. Tom, V. Chandran, J. Brockbank, C. Rosen, et al.

Development and initial validation of a screening questionnaire for psoriatic arthritis screen (ToPAS).

Ann Rheum Dis, 68 (2009), pp. 497-501

http://dx.doi.org/10.1136/ard.2008.089441 | Medline

[15.]

G.M. Alenius, B. Stenberg, H. Stenlund, M. Lundblad, S.R. Dahlqvist.

Inflammatory joint manifestations are prevalent in psoriasis: prevalence study of joint and axial involvement in psoriatic patients, and evaluation of a psoriatic and arthritic questionnaire.

J Rheumatol, 29 (2002), pp. 2577-2582

Medline

[16.]

W. Taylor, D. Gladman, P. Helliwell, A. Marchesoni, P. Mease, H. Mielants, the CASPAR study group.

Classification criteria for psoriatic arthritis.

Arthritis Rheum, 54 (2006), pp. 2665-2673

http://dx.doi.org/10.1002/art.21972 | Medline

Indexed in:

Follow us:

Indexed in:

Follow us:

Subscribe to our newsletter