Abstract
BackgroundThe early detection of psoriatic arthritis (PSA) poses a challenge to rheumatologists, even when their diagnosis is aided by sonography. In order to facilitate early detection of PSA among patients with psoriasis (PSO), we retrospectively analyzed of the relationships between serological markers and comorbidities in 629 psoriatic patients, 102 of which had PSA, while the other 527 had PSO.ResultsSerological markers were found not to be useful in distinguishing between PSA and PSO (p > 0.05 for all comparisons). The prevalence rate of PSA among PSO patients was around 19.4%. Two components of metabolic syndrome—hyperlipidemia (2.94%) and gout (4.9%)—were significantly more prevalent in PSA patients than in PSO patients (p < 0.05). The odds ratio for PSA is 15.94 in patients with hyperlipidemia with a 95% confidence interval (CI) of 1.64–154.80; meanwhile, the odds ratio for PSA is 3.83 in patients with gout with a 95% CI of 1.19–12.31. Allergic rhinitis (5.88%) was more prevalent in PSA patients than in PSO patients (p < 0.01). The odds ratio was 8.17 in patients with allergic rhinitis with a 95% CI of 2.26–29.50. Plasma hs-miR-210-3p distinguishes PSA from PSO, and its levels can also be distinguished from PSA after treated with anti-TNFα biologics agents (both p < 0.05).ConclusionsNo clinical available serology markers, but hyperlipidemia, gout, axial spondylopathy (inflammatory back pain), or allergic rhinitis, could differentiate between psoriatic arthritis from psoriasis. Plasma hs-miR-210-3p and comorbidities may differentiate psoriatic arthritis from psoriasis.Key Points• Clinical manifestations and comorbidities are different between psoriatic arthritis and psoriasis only patients.• Traditional serology markers are similar between psoriatic arthritis and psoriasis-only patients.• Plasma hs-miR-210-3p distinguishes PSA from PSO, and its levels can also be distinguished from PSA after treated with anti-TNFα biologics agents in our study.
Highlights
The early detection of psoriatic arthritis (PSA) poses a challenge to rheumatologists, even when their diagnosis is aided by sonography
PSA diagnoses were confirmed by chart review or the presence of a relevant ICD-9-CM code diagnosed by a rheumatologist
Our present results show a higher prevalence rate of hypertension in PSA patients (3.92%) than in PSO patients (1.33%), but the difference did not reach statistical significance (p = 0.09 with odds ratio 3.03, 95% confidence interval (CI) 0.87– 10.55)
Summary
The early detection of psoriatic arthritis (PSA) poses a challenge to rheumatologists, even when their diagnosis is aided by sonography. An update of the treat to target concept of a Canadian dermatologic expert suggested looking beyond the skin [3]. Such treat to target concept requires the early diagnosis and treatment of PSA [4, 5]. Using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes in a hospital database, we retrospectively identified and analyzed the medical records of all patients with psoriasis (PSO) or PSA but without any autoimmune diseases. One recent study reported that the prevalence rate of PSA is about 17% among PSO patients in dermatology clinics [6].
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