REVISITING PSORIATIC ARTHRITIS DETECTION IN PATIENTS WITH PSORIASIS IN A DERMATOLOGICAL HOSPITAL
The incidence of psoriatic arthritis (PsA) is increasing annually; the number of disabling cases of the disease grows as well. A dermatologist becomes the first contact physician for a patient with psoriasis, on whom timely detection of clinically manifest PsA signs and referral to a rheumatologist depend. The aim of this work was to perform PsA detectability analysis and to study the prevalence of comorbid diseases in psoriasis patients treated in a dermatological in-patient hospital. The study engaged 45 patients (including 13 women) with various clinical forms of psoriasis from among in-patients of the Republican dermatovenerologic dispensary of the town of Cheboksary. The examinees' median age was 49,3±12,8 years. Based on the mPEST screening questionnaire, PsA diagnosis was suspected in 20 (44,4%) patients, with 18 patients meeting the CASPAR disease classification criteria. Only 5 patients were diagnosed with PsA earlier, and the remaining patients, despite the symptoms of damage to the musculoskeletal system, were never consulted by a rheumatologist and were observed only in a dermatological clinic. Peripheral arthritis was detected in 22.2%, enthesites - in 33,3%, dactylites - in 33.3%, spondylites - in 8.9% of psoriasis patients. In 68.9% of psoriasis patients, concomitant diseases were detected. Diseases of the cardiovascular system (51,1% of cases) and gastrointestinal tract (33,3% of cases) were the most frequently reported. Almost 2/3 of the patients (62,3%) were overweight/obese. The rate of undiagnosed PsA among psoriasis patients treated in the dermatological in-hospital was 28,9%. Increasing the frequency of PsA detectability can be achieved through active using screening questionnaires by dermatologists, these questionnaires being aimed at identifying clinically manifest signs of damage to the bone and joint apparatus in psoriasis patients, and through developing the ways to route patients to be consulted by a rheumatologist.