AB0568 CORRELATION BETWEEN SKIN AND JOINT INVOLVEMENT IN PATIENTS WITH PSORIATIC ARTHRITIS: EXPERIENCE FROM A THIRD LEVEL HOSPITAL
Background: Determining the relationship between severity of skin and joint disease is essential for better phenotyping of patients and determine whether clinical features of arthritis can associate with psoriasis. Objectives: To characterize the relationship between skin and joint activity in patie...
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Published in | Annals of the rheumatic diseases Vol. 80; no. Suppl 1; p. 1321 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
London
BMJ Publishing Group LTD
01.06.2021
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Subjects | |
Online Access | Get full text |
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Summary: | Background:
Determining the relationship between severity of skin and joint disease is essential for better phenotyping of patients and determine whether clinical features of arthritis can associate with psoriasis.
Objectives:
To characterize the relationship between skin and joint activity in patients with psoriatic arthritis (PsA) and psoriasis (PsO) at enrolment.
Methods:
We performed a retrospective and descriptive study including patients diagnosed with PsA with a history of PsO. Age, sex, disease onset and duration, pattern of PsA and PsO, sites of skin and joint involvement were collected. PsA patients were evaluated at enrolment for skin activity by Psoriasis Area and Severity Index (PASI), joint activity by Disease Activity Score 28 (DAS28) for peripheral arthritis and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for axial involvement. A PASI>10% was used to define moderate-severe psoriasis (MS-P). We compared clinical characteristics of patients with PsA based on PASI score and evaluated the relationship of skin and joint activity with linear regression.
Results:
A total of 50 patients were collected, 64% were women with a mean age of 57.4 ±11.9 years. Patients with MS-P had a long-standing history of PsO (16.6±7.9 vs 14.15±8.2 years, p 0.03) and arthritis (12.2±7.6 vs 10.6±7.6 years, p 0.05). PsO was diagnosed more frequently before arthritis in the group of MS-P (73% vs 42%, p 0.03). Nail (73% vs 34%, OR 4.27 (1.38-20.14), p 0.015) and hairline psoriasis (67% vs 29%, OR 5 (1.36-18.35), p 0.03) were more frequent in the group of MS-P. Polyarthritis was the most common clinical pattern (60% vs 26%, p 0.02) and peripheral arthritis, in shoulder, elbows and wrists was more associated to patients with MS-P. No significant difference regarding sex, age, arthritis onset, dactylitis, enthesitis or HLA-B27 was found. Patients with MS-P had a higher joint activity for peripheral arthritis (4.1 vs 2.44, p 0.02). The correlation between the skin and joint activity was positive and statistically significant r=0.568 (p 0.02), (graph 1).
Conclusion:
Patients with PsA with MS-P associate nail and hairline psoriasis, polyarthritis, and peripheral joint involvement more often. Cutaneous disease activity is correlated with joint activity. Collaboration between dermatologists and rheumatologists is recommended for a proper assessment of psoriatic arthritis with skin involvement.
Graph 1.
Correlation between skin and joint activity
Table 1.
Demographic and clinical characteristics of 50 patients
PASI <10%
N = 35
PASI> 10%
N=15
OR 95%IC
P value
Age
54.4 ±10.4
53.9 ±12.9
-
0.86
Female
63%
73%
0.62 (0.16-2.34)
0.53
Duration of psoriasis
14.15 ±8.2
16.6±7.9
-
0.03
Duration of arthritis
10.6 ±7.4
12.2 ±7.6
-
0.05
Psoriasis onset
42%
73%
3.67 (1.97-13.8)
0.03
Arthritis onset
17%
20%
1.21 (0.26-5.64)
1
Nail psoriasis
34%
73%
4.27 (1.38-20.14)
0.015
Hair line
29%
67%
5 (1.36-18.35)
0.03
Enthesitis
14%
13%
1.08 (0.19-6.32)
0.96
Dactylitis
20%
33%
0.5 (0.13-0.96)
0.47
HLA B27
34%
13%
3.39 (0.66-17.56)
0.18
Type of arthritis
Axial
26%
13%
0.44 (0.08-2.36)
0.47
Peripheral
42.8%
73%
6.88 (1.77-26.76)
0.05
Both
31%
13%
0.34 (0.06-1.75)
0.29
Joint involvement
Back
14%
20%
0.67 (0.14-3.24)
0.68
Shoulders
17%
53%
5.52 (1.44-21.14)
0.02
Elbows
5.7%
33%
8.25 (1.38-49.21)
0.02
Wrists
31%
73%
6 (1.56-23.11)
0.01
Fingers
54%
60%
1.26 (0.37-4.32)
0.77
Knees
29%
47%
2.19 (0.63-7.65)
0.33
Ankles
40%
60%
2.25 (0.65-7.73)
0.22
Toes
46%
53%
1.36 (0.4-4.56)
0.76
Articular pattern
Polyarthritis
26%
60%
4.33 (1.2-15.61)
0.02
Asymmetric oligoarthritis
29%
27%
0.91 (0.23-3.54)
1
DIP involvement
14.3%
13.3%
0.92 (0.16-5.39)
1
Spondyloarthritis
11.4%
13.3%
1.19 (0.19-7.33)
1
Arthritis mutilans
-
-
-
-
DAS28
2.44 ±0.95
4.1±1.2
-
0.02
References:
[1]Mease PJ, Etzel CJ, Huster WJ. Understanding the association between skin involvement and joint activity in patients with psoriatic arthritis: experience from the Corrona Registry. RMD Open. 2019 May 24;5(1):e000867. doi: 10.1136/rmdopen-2018-000867. PMID: 31245045; PMCID: PMC6560
Disclosure of Interests:
None declared. |
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ISSN: | 0003-4967 1468-2060 |
DOI: | 10.1136/annrheumdis-2021-eular.1226 |