The Role of the Dermatologist in Identification and Treatment of the Early Stages of Psoriatic Arthritis

Skin Therapy Letter. 2008;13(4):4-8. 

In This Article

Abstract and Introduction

Early diagnosis of psoriatic arthritis (PsA) is essential for preventing disease progression and joint destruction. The majority of patients develop PsA years after the onset of their skin disease. Therefore, dermatologists are in a strategic position to make the diagnosis of PsA, and either manage it or refer the patient to a rheumatologist in order to prevent the potentially irreversible destruction of the affected joints. We will review the presentation and temporal relationship of psoriasis and PsA, the diagnosis, classification, and management, in addition to the role of the dermatologist in the early detection of PsA.

Psoriatic arthritis (PsA) is often described as a chronic, inflammatory arthropathy affecting the distal interphalangeal joints (DIP) of the hands, metatarsophalangeal joints (MTP) of the feet, and spine in association with psoriasis.[1] One to three percent of the world population has been diagnosed with psoriasis.[2]

Estimates of the prevalence of PsA within the psoriasis population range from 6%-39%.[3] The Psoriasis Foundation 2001 Benchmark Survey estimated the prevalence of PsA in patients with psoriasis to be as high as 23%.[4] PsA is often under diagnosed or misdiagnosed, and therefore, statistics may be misrepresented.


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