Psoriatic arthritis can often go undiagnosed in patients with psoriasis, and earlier diagnosis is critical to prevent the adverse effects of psoriatic arthritis, according to a staff rheumatologist at Women’s College Hospital in Toronto, Scientist at Women’s College Research Institute, and assistant professor in the department of medicine at the University of Toronto, who spoke at the Atlantic Dermatological Conference in May.
“Psoriatic arthritis is a chronic condition that can be a destructive disease that causes joint damage,” Lihi Eder M.D., Ph.D., tells Dermatology Times. “Arthritis causes a major burden on a patient’s life. It affects mobility, quality of life, and productivity, and there are risks of other co-morbidities like heart disease, diabetes, and depression.”
Indeed, in one psoriatic arthritis comorbidity study, hypertension was present in 37% of psoriatic arthritis patients while it was present in only 20% of patients who had psoriasis only.1 Type II diabetes mellitus and obesity were also more common in patients with psoriatic arthritis than in patients with psoriasis only.2 Patients who have psoriatic arthritis compared to patients with only psoriasis had more neurologic diseases, like neuropathy or multiple sclerosis, as well as greater hepatic impairment and gastrointestinal diseases.1
Dr. Eder cites a multi-country prevalence study that involved 949 patients where almost a third of patients with psoriasis seen in dermatology centers had psoriatic arthritis as determined by a rheumatologist. A total of 41% of the 285 patients who were given a diagnosis of psoriatic arthritis had not been supplied with a previous diagnosis of psoriatic arthritis, illustrating under-diagnosis of psoriatic arthritis in patients with psoriasis who had been seen in dermatology clinics.3
A study from Sweden of 197 patients with psoriatic arthritis who were followed for five years concluded that radiography and scoring of the hands and feet at baseline are critical steps and cannot be substituted for clinical signs of disease.4