Abstract
Objective: Psoriatic arthritis mutilans (PAM) is the most severe phenotype of psoriatic arthritis due to excessive bone erosion causing joint destruction and decreased functional capacity. The aim of this study was to investigate the prevalence of comorbidities among patients with PAM and the association between comorbidities and joint involvement.Methods: A total of 66 patients aged ≥18 years from the Nordic countries with past or present psoriasis along with at least one mutilated joint were included in the present study.Results: The median number of comorbid conditions per patient was 1 [interquartile range (IQR) 0–2] and 16.7% reported three or more comorbidities. The most frequent comorbidity was hypertension (36.4%). The median number of mutilated joints per patient was 3 (IQR 1–8.3; range 1–38).Conclusion: Two thirds of the patients with PAM reported comorbid conditions and the most frequent was hypertension which affected more than a third of the patients. However, this study was unable to detect any association between comorbidities and the severity of PAM.
Highlights
Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease affecting 20–30% of patients with psoriasis [1,2,3]
Patients were identified as part of The Nordic psoriatic arthritis mutilans (PAM) Study initiated in 2009 to investigate PAM in the Nordic countries
Included patients met the following inclusion criteria: (I) able and willing to give written informed consent; (II) age ≥18 years; (III) past or present psoriasis diagnosed by a dermatologist; (IV) presence of clinical arthritis of the PAM type verified by a rheumatologist; and (V) radiological findings of severe erosive arthritis, e.g., pencilin-cup or gross osteolysis of the bones
Summary
Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease affecting 20–30% of patients with psoriasis [1,2,3]. In the majority of patients with PsA, skin affection precedes arthritis by several years [4]. Variable clinical presentations have given rise to five PsA subtypes: arthritis in the distal interphalangeal joints, asymmetric oligoarthritis, symmetric polyarthritis, axial spondyloarthritis, and psoriatic arthritis mutilans (PAM) [6]. Any of these subtypes may be present in different combinations and the disease pattern may change over time [4, 7]
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