Abstract

BackgroundPsoriasis (PsO) is an inflammatory disease associated with psoriatic arthritis (PsA). PsA affects peripheral and axial joints1,2. Psoriasis can precede the onset of PsA by approximately 3 to 8 years, axial involvement often undiagnosed3. There are limited data about the prevalence of inflammatory back pain (IBP) in PsO patients (pts) without clinical symptoms of PsA4.ObjectivesTo study the prevalence of IBP in PsO pts without PsA symptomsMethods108 PsO pts without PsA over a 10-month period (March 2021 to December 2021) were incluided. Participants filled out a questionnaire on IBP. Additionaly the prevalence of stiffness in the back and neck was estimated. IBP was defined as an affirmative answer to the question ‘Did you suffer from low back pain for ≥3 months?’ and IBP criteria was based on criteria ASAS (the ASsessment in Ankylosing Spondylitis) and was confirmed if at least 3 out of the following 4 criteria were present: (a) onset before age 40, (b) insidious onset, (c) improvement with exercise, (d) associated with morning stiffnessResultsIt was found that more than 40% of patients complained of pain or stiffness in the back. Stiffness and pain in the neck were observed in every fourth patient on average. Of those patients who complained of pain in the back or neck, 37% noted that they had pain at rest (when they get up in the morning or lie down for a long time), and 21.3% had inflammatory pain at night (when patients are forced to woke up, they needed to do exercises) (Table 1). It was found that the risks of developing spondylitis with neck pain, neck stiffness, back pain, back stiffness were higher in 4,549 times (95% CI [1,720; 12,031]), in 19,444 times (95% CI [6,480; 58,343]) 15 times (95% CI [4.646; 48.427]) and 34.857 times (95% CI [7.583; 160.230]), respectively.ConclusionIBP was found in more than 40% PsO patients. Every fourth PsO patients complained of stiffness and pain in the neck. The presence of these symptoms significantly increased the risk of developing PsA with spondylitis. The presence of IBP should be taken into account for early diagnosis of PsA in the dermatological practice.

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