engleski

No correlation of psoriasis with clinical features, measures of severity and activity in psoriatic arthritis

Background. Psoriatic arthritis (PsA) is a multi- faceted disease that may involve arthritis of peripheral joints, skin disease, entheseal involvement, dactylitis and axial disease. The relationship between skin and joint disease is poorly understood. The aim of the study was to investigate the correlation of severity of psoriasis with some clinical features, measures of severity and activity of PsA. Material and methods. Seventy-six consecutive adult patients of both genders (42 men, 34 females) with established diagnosis of PsA and psoriasis were enrolled in the study (mean age 56.2811.23 years). Severity of psoriasis was assessed using Psoriasis Area Severity Index (PASI). Assessment of PsA included evaluation of the following variables: tender joint count (TJC) (68 joints), swollen joint count (SJC) (66 joints), duration of morning stiffness (in minutes), presence of dactylitis (yes/no), number of fingers and toes affected with dactylitis (0-20), presence of enthesitis (yes/no), enthesitis (MASES) index (0-13), patient’s global assessment (PGA), examiner’s global assessment (EGA) and erythrocyte sedimentation rate (ESR) (mm/ 1 hour). Patients were classified into five clinical types of PsA (according to Moll and Wright). Apart from descriptive statistics, Spearman’s correlation coefficient and Kruskall Walis non-parametric test were used to investigate the association of PASI with parameters of PsA. Results were adjusted according to gender and age, as well as according to duration of PsA and psoriasis. The significance was set up at p=0.05. Results. Duration of psoriasis was 264126.56 months, while duration of PsA was 163.07105.81 months. Total PASI was 11.941.48, .dactylitis was present in 54.1% patients and 76.3% of them had clinical signs of enthesitis. Duration of morning stiffness was 45.006.21 minutes. Results for other variables were: TJC=20.252.25, SJC=9.021.17, PGA=46.262.72, EGA=59.552.60, and ESR=23.631.98. No correlation of PASI with any of variables was found. The only exception was the correlations of PASI with the presence of enthesitis (p=0.013), which persisted if adjusted for age (p=0.043) or for duration of the disease (p=0.027). Conclusions. In this cross-sectional study of patients with PsA no correlation of PASI and several parameters of disease activity and severity was found, with the exception of enthesitis.

psoriatic arthritis; psoriasis; severity; activity

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