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Review

Defining Pre-Clinical Psoriatic Arthritis in an Integrated Dermato-Rheumatology Environment

1
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS7 4SA, UK
2
Chapel Allerton Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds LS7 4SA, UK
3
Rheumatology Unit, IRCCS Sacro Cuore Don Calabria, 37024 Negrar, Italy
4
Department of Medical and Biological Sciences, Rheumatology Clinic, University Hospital Santa Maria della Misericordia, 33100 Udine, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(10), 3262; https://doi.org/10.3390/jcm9103262
Received: 3 September 2020 / Revised: 24 September 2020 / Accepted: 7 October 2020 / Published: 12 October 2020
In excess of three quarters of patients with psoriatic arthritis (PsA) have preceding psoriasis (PsO), which offers a clinical biomarker for the recognition of early PsA. Numerous surveys have shown a remarkably high frequency of clinically occult musculoskeletal symptoms in psoriasis patients. Imaging studies, particularly ultrasound, show a high prevalence of subclinical enthesitis and other inflammatory changes in psoriasis subjects. Since a serum biomarker, such as the case of anti-citrullinated protein antibodies (ACPA) in rheumatoid arthritis, neither exists nor seems biologically plausible at this point, this article explores how integration of rheumatological and dermatological assessment can be facilitated for the early recognition of potential PsA. Given that scalp disease is a PsA predictor, but may be managed in the community, then a particular need to access this group is needed. An integrated approach between rheumatology and dermatology can involve joint clinics, parallel clinics with discussion of relevant cases or virtual contact between specialties. Early therapy evaluation and integrated strategies have considerable implications for minimizing suffering and joint damage in PsA. View Full-Text
Keywords: psoriasis; psoriatic arthritis; integrated dermato-rheumatology clinic; psoriatic arthralgia; pre-clinical psoriatic arthritis psoriasis; psoriatic arthritis; integrated dermato-rheumatology clinic; psoriatic arthralgia; pre-clinical psoriatic arthritis
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MDPI and ACS Style

Savage, L.; Tinazzi, I.; Zabotti, A.; Laws, P.M.; Wittmann, M.; McGonagle, D. Defining Pre-Clinical Psoriatic Arthritis in an Integrated Dermato-Rheumatology Environment. J. Clin. Med. 2020, 9, 3262. https://doi.org/10.3390/jcm9103262

AMA Style

Savage L, Tinazzi I, Zabotti A, Laws PM, Wittmann M, McGonagle D. Defining Pre-Clinical Psoriatic Arthritis in an Integrated Dermato-Rheumatology Environment. Journal of Clinical Medicine. 2020; 9(10):3262. https://doi.org/10.3390/jcm9103262

Chicago/Turabian Style

Savage, Laura, Ilaria Tinazzi, Alen Zabotti, Philip M. Laws, Miriam Wittmann, and Dennis McGonagle. 2020. "Defining Pre-Clinical Psoriatic Arthritis in an Integrated Dermato-Rheumatology Environment" Journal of Clinical Medicine 9, no. 10: 3262. https://doi.org/10.3390/jcm9103262

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