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One-third of patients with psoriasis have PsA in a Brazilian cohort

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Approximately one-third of patients with psoriasis from a Brazilian cohort also had psoriatic arthritis, half of whom had not been previously diagnosed or properly treated, according to study findings.

In a cross-sectional, multicenter study conducted at four university dermatology clinics between January and March 2011, researchers evaluated 524 patients with psoriasis. Half of the patients were women; mean age was 48.5 years, and mean psoriasis duration was 15.4 years.

A detailed medical history was taken, and information about psoriasis characteristics was collected. A rheumatologist performed a physical examination focused on musculoskeletal involvement, and radiographs and laboratory tests were taken on an as-needed basis at the judgment of the rheumatologist on the same day.

Most patients had plaque psoriasis (78.8%), with a mean Psoriasis Area and Severity Index (PASI) score of 8.2, and nearly 60% of patients were being treated systemically for their dermatologic condition, according to the researchers. Additionally, psoriatic nail involvement was present in 50.8% of the patients.

Of the patients with psoriasis, 233 (44.5%) had no other rheumatic conditions; osteoarthritis (OA) or chromic myofascial pain (CMP) was seen in 116 (22.1%) patients, and psoriatic arthritis (PsA) was seen in 175 (33.3%) of patients. PsA was associated with OA or CMP in 38 (7.2%) of patients. In 42 of the patients with PsA, laboratory or radiographic tests were performed to establish the diagnosis. Overall, the researchers established a new diagnosis of PsA in 86 psoriasis patients after rheumatological assessment, and a prior diagnosis was confirmed in 89 patients.

Further analysis revealed similar sex distributions and skin involvement between patients with psoriasis and PsA, but patients with PsA tended to be older (50.6 years vs. 47.5 years), were less frequently white (78% vs. 65%) and were more likely to present nail involvement (59.2% vs. 46.8%). However, multivariate regression analysis showed that male sex may be a protective factor against PsA, according to the researchers. – by Shirley Pulawski

Disclosure: No financial disclosure information was available at the time of publication.