Symptoms dermatologists should look for in detection of psoriatic arthritis

[Fred]

This expert group consensus article published in The Journal of the European Academy of Dermatology and Venereology proposes a set of four items to screen psoriasis patients for psoriatic arthritis for routine clinical use by dermatologists.

Quote:

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Background:
Up to 29% of patients with psoriasis seen by dermatologists have undiagnosed psoriatic arthritis (PsA). As early detection of PsA may be associated with improved joint and skin outcomes, it is essential for dermatologists to improve their ability to diagnose PsA. Skin and nail features of psoriasis associated with PsA are well known to dermatologists but they may feel less confortable assessing other symptoms and they rarely use PsA screening questionnaires.

Objective:
To develop a limited list of clinical signs and symptoms that a dermatologist should be looking for in a psoriasis patient in addition to specific skin features and nail involvement, to improve PsA detection.

Methods:
A systematic search was performed in pub med, Cochrane and Embase databases to identify clinical key symptoms associated with PsA. It yielded 27 studies in which we extracted a list of clinical signs and symptoms observed in PsA and submitted it to a panel of dermatology experts through a DELPHI selection process. The experts had to determine which minimal set of signs and symptoms dermatologists should look for in daily practice to improve detection of PsA in patients with psoriasis.

Results:
The four items that received a score higher than 90% in the DELPHI process were finally selected. Those items were as follows: peripheral inflammatory pain (100%), axial inflammatory pain (95.3%), dactylitis (93%), buttock and sciatic pain (90.7%). The remaining items: distal interphalangeal joints (DIPs) involvement (83.7%), Talalgia (79.1%), swollen Achille's tendon (41.9%), costo-chondral involvement (32.6%), uveitis (7%), mouth ulcerations (2.3%), were not retained.

Conclusion:
We propose a set of four items to screen psoriasis patients for psoriatic arthritis for routine clinical use by dermatologists.

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[jiml]

I think it's a great idea to screen psoriasis patients for PSA in all the years I have attended hospital I have only had it mentioned in passing.
They check my skin, nails and scalp and sometimes ask if I have any joint pain, but never peruse it.
So anything to standardise diagnosis must be a plus, in my opinion

[Fred]

I think it's a great idea to screen psoriasis patients for PSA in all the years I have attended hospital I have only had it mentioned in passing.
They check my skin, nails and scalp and sometimes ask if I have any joint pain, but never peruse it.
So anything to standardise diagnosis must be a plus, in my opinion

Yes they usually wait for you to start complaining about the pain, but knowing what was coming would help. Having psoriasis is bad enough but psoriatic arthritis is much worse, give me flakes on the chair any day over being unable to move.

So come on dermatologists, check us out for psoriatic arthritis whilst we are there.

[Caroline]

Very good thing to check this.
Sensible study.