High prevalence of psoriatic arthritis in dermatological patients with psoriasis: a cross-sectional study

Abstract

The exact prevalence of psoriatic arthritis (PsA) among patients with psoriasis is still not conclusive. Data in the literature vary between 5.8 and 30 %. Objective of this study was to gain more information on the prevalence of PsA among patients with psoriasis in Germany. Between 09/2010 and 05/2011, consecutive patients from dermatological private practices and a university hospital with psoriasis were asked to fill out the validated German Psoriatic Arthritis Diagnostic (GEPARD) Questionnaire. Patients who answered ≥4 questions with "yes" were invited to come for a rheumatological check up. Those patients who refused a rheumatological examination were counted as "absence of PsA". Laboratory tests for inflammatory markers as well as the severity of skin manifestations were assessed. The diagnosis of PsA was made according to the CASPAR criteria, and imaging was performed in addition. A total of 404 questionnaires were evaluated; 50.5 % answered ≥4 questions positively; 19.3 % had a history of PsA confirmed by a rheumatologist; and in 10.9 %, PsA or spondyloarthritis was newly diagnosed during the present study. This leads to an overall prevalence of PsA in patients with psoriasis of 30.2 %. The frequency of psoriatic arthritis in the present study is higher than expected from previous studies in Germany. The prevalence is consistent with findings of a large observational survey from Scandinavia. Using the CASPAR criteria and imaging in all patients, certainty of the diagnosis is very high. The GEPARD Questionnaire is a helpful tool to identify people at risk for psoriatic arthritis.

Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: Systematic review and meta-analysis

“…In 7 of 12 studies, the final diagnosis was made by a senior rheumatologist 2,12,[15][16][17]21,22 ; in the 5 other studies, it was not stated who was responsible for the final diagnosis of PsA. 13,14,[18][19][20] CASPAR, GRAPPA, Moll and Wright criteria, as well as the rheumatologists' assessments were used to make the final diagnosis of PsA (Table I). When considered, in 1 study, 2 laboratory tests and imaging results did not markedly alter the prevalence of PsA based on the rheumatologists' assessment of medical history and clinical examination alone.…”

Prevalence of psoriatic arthritis and its correlates among patients with psoriasis in Greece: results from a large retrospective study

“…A possible explanation for this discrepancy could be the geographical variation in PsA. Europe and North America present higher PsA prevalence ranging between 20.6% to 30% compared with Asia where PsA is significantly lower (8.7%) as seen in a large study of 1149 patients . The data from South America are conflicting.…”

Nail psoriasis as a predictor of the development of psoriatic arthritis

“…[2][3][4] An estimated 20---30% of psoriasis patients may develop PsA. 5,6 Imaging studies have demonstrated the existence of considerable number of patients with psoriasis and undiagnosed PsA, a reflection of the presence of subclinical arthritic disease in clinically normal joints. 7,8 Persistent joint inflammation can lead to bone damage, and it is estimated that half of PsA patients develop irreversible joint lesions within the first few years of disease.…”