Субклинический псориатический артрит в популяции больных псориазом

Abstract

Psoriasis (PsO) is a chronic immune-mediated disease, in the pathogenesis of which various risk factors and genetic predisposition play an important role. Psoriatic arthritis (arthropathic psoriasis, PsA) is a chronic inflammatory disease of the joints, spine, and entheses that can occur in patients with psoriasis. Every fourth patient with PsO of smooth skin develops psoriatic arthritis (PsA), which, if progressed and left untreated, can cause irreversible functional disorders, which necessitates early diagnosis of this disease. The aim of the study was to assess the frequency of detection of PsA in patients with PsO in the dermatovenerological department of the regional dermatovenerological dispensary using the mPEST questionnaire. The study involved 128 patients (73 men and 55 women, mean age 45 ± 13.69 years) with different clinical forms of PsO who received treatment in the adult dermatovenereology department No. 1 of the regional dispensary in the period from 2019 to 2021. The duration of the disease lasted an average of 6.1±2.76 years. Patients with PsO were divided into 3 groups according to the clinical manifestations of the skin process. The first group (n=96) included patients with an established clinical diagnosis of vulgar (common) psoriasis (PsO(c) without damage to the nail plates. The second group (n=24) was diagnosed with exudative psoriasis (PsO(e)). the third group (n=8) included patients with lesions of the skin and nail plates (PsO(o)). Based on mPEST≥3, the diagnosis of PsA was suspected in 34 (35.41%) patients diagnosed with PsO(c). In 10 (41.66%) patients of the second group with a diagnosis of PsO(e) and in 3 (37.5%) patients of the third. According to the results of the DLQI questionnaire, a moderate effect of the skin process on the quality of life was revealed in the first group of patients with PsO(c), which amounted to 10 points. In the second PsO(e) and third PsO(o) groups, a strong influence of the skin process on the quality of life was revealed - 18 and 11 points, respectively. The diagnosis of PsA in the first group with a diagnosis of PsO(c) according to the BASDAI questionnaire can be suspected in 85 (86.73%) patients, in group II - in 21 (87.5%) patients, in group III - PsA - in 7 (87.5%) %) of patients.