From the Guidelines
Psoriatic arthritis is more related to arthropic psoriasis, as arthropic psoriasis is another term for psoriatic arthritis, a specific type of inflammatory arthritis affecting some people with psoriasis. The connection between the two conditions involves shared inflammatory pathways, with both being autoimmune disorders where the immune system inappropriately attacks healthy tissue 1. According to the 2019 American College of Rheumatology/National Psoriasis Foundation guideline for the treatment of psoriatic arthritis, psoriatic arthritis affects men and women equally, and the distribution of the peripheral arthritis varies from asymmetric oligoarthritis to symmetric polyarthritis 1.
The prevalence of psoriatic arthritis among patients with psoriasis has varied between 6% and 41% 1, and approximately 30% of individuals with psoriasis will develop psoriatic arthritis 1. The condition typically causes pain, stiffness, and swelling in affected joints, and can range from mild to severe. Treatment typically involves medications that target both skin and joint symptoms, including nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs) like methotrexate, and biologics such as TNF inhibitors (adalimumab, etanercept) or IL-17 inhibitors (secukinumab, ixekizumab) 1.
Key points to consider in the management of psoriatic arthritis include:
- Early diagnosis and treatment are crucial to prevent progressive joint damage 1
- A holistic approach to comorbidity is essential, as psoriatic arthritis is associated with a greater risk for clinical and subclinical diabetes and cardiovascular disease 1
- The EULAR 2023 update recommends a treatment target of remission or low disease activity, and emphasizes the importance of a multidisciplinary approach to patient care 1
- The choice of pharmacological therapy should be individualized, taking into account the patient's disease severity, comorbidities, and preferences 1
From the Research
Relationship Between Psoriatic Arthritis and Psoriasis
- Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects multiple organ systems and is characterized by skin and joint manifestations, often associated with psoriasis 2.
- Approximately 20% of patients with psoriasis suffer from a moderate to severe form of skin disease, and up to 30% have joint involvement, which can be classified as psoriatic arthritis 3.
- The prevalence of psoriatic arthritis varies from 20–420 per 100,000 population, and it affects both genders equally, often following long-standing psoriasis 4.
Comparison of Psoriatic Arthritis and Psoriasis
- Psoriatic arthritis is part of a group of closely related clinical phenotypes ('psoriatic disease') that share molecular pathogenesis, resulting in excessive, prolonged inflammation in various tissues, including the skin, entheses, and joints 5.
- Psoriasis is a chronic, immune-mediated inflammatory disease affecting both the skin and joints, with standard therapies including topical medications, phototherapy, and oral systemic and biological therapies 3.
- The diagnosis of psoriatic arthritis can be made in the presence of typical skin lesions, but it can also be made in the absence of skin lesions using the Classification of Psoriatic Arthritis criteria 4.
Arthropic Psoriasis
- There is no direct mention of "arthropic psoriasis" in the provided studies, but based on the information available, it can be inferred that psoriatic arthritis is more closely related to arthropic manifestations, as it is a chronic inflammatory disease that affects the joints 6, 3, 2, 4, 5.
- Psoriatic arthritis has been grouped into five subtypes, including distal interphalangeal (DIP) predominant, symmetrical polyarthritis, asymmetrical oligoarthritis and monoarthritis, predominant spondylitis, and arthritis mutilans, which can cause arthropic symptoms 4.