Nail Psoriasis Research Articles

Advantages of IL-17 inhibitor, ixekizumab, in the treatment of severe psoriasis

Psoriasis is a common immune-mediated disease, often accompanied by inflammatory and metabolic disorders. About 20–30% of patients have moderate to severe psoriasis and require systemic methods of treatment, which include conventional, targeted and genetically engineered biological drugs (GEBDs). When selecting a biological agent, a number of factors must be considered related to the disease, patient and therapy. Assessment of severity and activity, area of skin affected, frequency of relapses, pruritus and other symptoms, the presence of comorbidities, especially psoriatic arthritis (PsA), are important. The presence of comorbidities that may contribute to or interfere with the use of GEBD is the main factor determining personalised therapy. Personalised treatment implies maximum efficacy and minimum risk of side effects. In addition, it is possible to modify the course of the disease, inducing long-term remission and preventing the development of PsA, which is possible in case of timely prescription of GEBD. To date, several classes of GEBDs are available in the arsenal of dermatovenerologists, among which interleukin (IL) inhibitors have the highest efficacy and safety. The drug ixekizumab is a member of the IL-17 inhibitor group, a monoclonal antibody of the IgG4 class that binds to IL-17A with high affinity and specificity. The drug has shown high efficacy and reliable safety profile in the treatment of psoriasis and PsA within the framework of numerous clinical trials and studies of real clinical practice, including in patients with an aggravated comorbid background and with involvement of hard-to-treat localisations. The presented article presents key data of safety and efficacy studies of ixekizumab therapy, describes a clinical case of successful treatment of a patient with psoriasis and psoriatic onychodystrophy. Timely initiation of therapy helped to stop the progression of the disease and significantly improved the quality of life of the patient. Thus, the presented data confirm the advantages of ixekizumab in psoriasis treatment.

Guselkumab provides durable improvement across psoriatic arthritis disease domains: post hoc analysis of a phase 3, randomised, double-blind, placebo-controlled study

ObjectiveEvaluate long-term guselkumab effectiveness across Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-recognised domains/related conditions of psoriatic arthritis (PsA).MethodsPost hoc analyses used data from DISCOVER-2 (NCT03158285) biologic/Janus-kinase...

Measuring Psoriasis Severity at Home.

Psoriasis plaque severity metrics, such as induration (thickness), erythema (redness), and desquamation (scaliness), are associated with the subsequent development of psoriatic arthritis (PsA) among cutaneous-only psoriasis patients (patients with skin or nail psoriasis but no psoriatic arthritis). These metrics can be used for PsA screening. However, a key challenge in PsA screening is to optimize accessibility and minimize costs for patients, while also reducing the burden on healthcare systems. Therefore, an ideal screening tool consists of questions that patients can answer without a physician's assistance. Although reference images can be used to help a patient self-assess erythema and desquamation severity, a patient would need a tactile induration reference card to self-assess induration severity. This protocol describes how to create an induration reference card, the Psoriasis Thickness Reference Card, as well as how to use it to assess lesion induration severity. Administration of reference images for erythema and desquamation and a Psoriasis Thickness Reference Card for induration to 27 psoriasis patients showed that patients were moderately successful at self-assessing the severity of these three metrics. These findings support the feasibility of a future PsA screening test that patients can complete without the need for physician assistance.

Foot involvement in psoriatic arthritis: Prevalence, clinical and radiological features

BackgroundThe purpose of this study was to evaluate the prevalence of foot involvement in psoriatic arthritis and to describe its different clinical and radiological features. Patients and MethodsWe conducted a cross sectional study including 40 patients with psoriatic arthritis over a period of 12 months. Anamnesis, clinical examination of feet, podoscopic examination, X-rays of feet and heels, and ultrasound in B mode and power Doppler mode were done for each patient. ResultsFoot involvement was found in 95% of cases. It was symptomatic in 70% and inaugural of the disease in 20% of cases. The hindfoot and the forefoot were the sites most affected (77.5% and 47.5% respectively). The involvement of the midfoot was rarer (25%). Dactylitis was found in 17.5% and deformities of forefoot were found in 22.5% of cases. Antalgic gait was noted in 17.5% and static disorders of foot at podoscopic examination were identified in 35% of cases. Feet dermatological manifestations were found in 45% of cases. Diagnosis of different rheumatological manifestations was based on clinical findings and caracteristic radiological images on X-rays. We demonstrate he sensitivity of ultrasound in the detection and the diagnosis of different foot lesions including enthesitis, synovitis and tenosynovitis, dactylitis, bone erosions and psoriatic nail dystrophy.

Association of the clinical components in the distal interphalangeal joint synovio-entheseal complex and subsequent response to ixekizumab or adalimumab in psoriatic arthritis.

To assess the frequency of simultaneous distal interphalangeal (DIP) joint disease and adjacent nail psoriasis (finger unit) among patients with psoriatic arthritis (PsA) and compare the efficacy of the IL-17A antagonist ixekizumab (IXE) and the TNF-α inhibitor adalimumab (ADA). This post hoc analysis evaluated the simultaneous occurrence of DIP joint involvement (tenderness and/or swelling) and adjacent nail psoriasis among patients with PsA from the SPIRIT-H2H (NCT03151551) trial comparing IXE to ADA. Among patients with simultaneous DIP joint involvement and adjacent nail psoriasis in ≥1 digit at baseline, treatment effects were assessed through week 52 for each affected finger unit; 'finger unit' defines the connected DIP joint and adjacent nail of an individual digit. A total of 354 patients had simultaneous DIP joint involvement and adjacent nail psoriasis in ≥1 finger unit at baseline. Among them, 1309 (IXE: 639; ADA: 670) finger units had baseline DIP joint tenderness and/or swelling and adjacent nail psoriasis. Proportions of affected finger units achieving complete resolution were significantly higher with IXE vs ADA as early as week 12 (38.8% vs 28.4%, P < 0.0001) and at all post-baseline assessments through week 52 (64.9% vs 57.5%, P = 0.0055). In this study cohort, patients with DIP joint involvement almost always had adjacent nail psoriasis. Greater resolution of DIP joint tenderness, swelling and adjacent nail psoriasis was achieved at all time points over 52 weeks through targeting IL-17A with IXE than TNF-α with ADA, which is noteworthy given prior comparable musculoskeletal outcomes for both drug classes.

Ayurvedic Management of Utthana Vatarakta – A Case Report

A 59-year-old upper-middle-class woman residing in Shornur for the past 10 years and having worked as a nurse for 33 years was admitted to Vaidyaratnam Ayurveda College hospital on September 27, 2023, for a 15-day duration, presenting with complaints of multiple joint pain, left-sided headache, itching of the whole body, crawling sensation persisting for a decade, and blackish discoloration of nails in both upper and lower limbs consistent with nail psoriasis. The diagnosis for this case was established as Utthana Vatarakta, seronegative arthritis. Comprehensive treatment approach involving internal medicines, Rukshana, Snehana, Swedana, Sodhana, and Samana therapies was implemented. Following the 15-day treatment regimen, the patient experienced significant alleviation of complaints improvement in Ama Assessment tool scoring, Visual Analog Scale and Clinical disease activity index.

Rapid response of nail psoriasis to secukinumab in patients with moderate to severe psoriasis after 12 weeks of treatment with a total of 24 weeks of follow-up.

Nail psoriasis, a subtype of psoriasis, can cause significant pain, disability, and reduced quality of life. Despite the established efficacy of anti-IL17 secukinumab in improving skin psoriasis, there is a lack of clinical trials focusing on nail psoriasis as primary endpoint. This study aims to investigate the efficacy of secukinumab in treating nail psoriasis in patients with moderate to severe psoriasis. We prospectively recruited patients newly diagnosed with moderate to severe psoriasis in single centre from January 2021 to January 2022 who were treated with secukinumab. A total of 16 patients consisting of 9 males and 7 females were included. Their mean age was 38.88 ± 10.29 years. They had an average initial Nail Psoriasis Severity Index (NAPSI) score of 45.06 ± 20.39 and an average NAPSI score at 12 weeks of 8.94 ± 13.50, showing a significant (p < 0.05) decrease of NAPSI score after 12 weeks of secukinumab treatment. After 24 weeks of treatment, NAPSI score was decreased to 5.12 ± 8.52. Secukinumab rapidly improved nail psoriasis after 12 weeks of treatment, with further enhancement at 24 weeks, suggesting its potential as a potent therapeutic option for nail psoriasis.

Effectiveness, Tolerability, and Drug Survival of Risankizumab in a Real-World Setting: A Three-Year Retrospective Multicenter Study-IL PSO (ITALIAN LANDSCAPE PSORIASIS).

Risankizumab is a humanized monoclonal antibody that selectively inhibits interleukin-23. It has been approved for moderate-to-severe plaque psoriasis and has shown efficacy and safety in clinical trials and real-world experiences. This study aimed to evaluate the long-term effectiveness, safety, and drug survival of risankizumab in a real-life setting. We included patients treated with risankizumab from January 2019 to February 2023. A Psoriasis Area and Severity Index score (PASI) was collected at weeks 0, 16, 28, 52, 104, and 156, when available. The occurrence of any adverse events was recorded at each visit. We enrolled 1047 patients. At week 52, a ≥90% improvement in PASI was observed in 81.44% of patients, with a continuous improvement throughout the study (88.99% and 99.07% at weeks 104 and 156, respectively). After three years of treatment, all patients involving the scalp, palms/soles, and genitalia and 95% of patients with nail psoriasis achieved a complete or almost complete skin clearance. No significant safety findings were observed, and 90.73% of the patients were still on treatment after 36 months. This study supports the long-term effectiveness and safety of risankizumab in a real-world setting, even in patients involving difficult-to-treat areas.

Efficacy of long-term risankizumab treatment for moderate-to-severe plaque psoriasis: Subgroup analyses by baseline characteristics and psoriatic disease manifestations through 256 weeks (LIMMitless trial).

Psoriasis is an inflammatory skin disease that impacts a heterogeneous group of patients and can have multiple clinical manifestations. Risankizumab is approved for the treatment of moderate-to-severe plaque psoriasis. To evaluate the long-term efficacy of risankizumab according to baseline patient characteristics, and for the treatment of high-impact disease manifestations (nail, scalp and palmoplantar psoriasis), through 256 weeks of continuous treatment in the phase 3 LIMMitless study. This subgroup analysis evaluated pooled data from patients with moderate-to-severe plaque psoriasis who were randomized to risankizumab 150 mg during two double-blind, phase 3, 52-week base studies (UltIMMa-1/2; NCT02684370/NCT02684357) and were enrolled in the phase 3 LIMMitless open-label extension study (NCT03047395). Subgroup assessments included the proportion of patients who achieved ≥90%/100% improvement in Psoriasis Area and Severity Index (PASI 90/100). Among patients with nail, scalp and/or palmoplantar psoriasis in addition to skin psoriasis, assessments included changes from baseline in and resolution of these three psoriatic manifestations. Overall, a numerically similar proportion of patients (N = 525) achieved PASI 90/100 through Week 256, regardless of their baseline age, sex, body mass index, weight, PASI or psoriatic arthritis status. Patients with nail, scalp and/or palmoplantar psoriasis experienced substantial improvements in manifestation-specific indices (mean improvement from baseline to Week 256 of >81%, >94% and >97%, respectively); in patients with all three manifestations (N = 121), 44.6% achieved complete clearance of these manifestations at Week 256. Risankizumab demonstrated generally consistent efficacy through 256 weeks across patient subgroups and showed durable long-term efficacy for psoriatic disease manifestations.

Nail Psoriasis: Clinical Features and Severity Assessment.

The nail is an important characteristic in the context of psoriasis. Nail psoriasis exhibits several clinical manifestations. Since the development of the Nail Psoriasis Severity Index (NAPSI) score assessment tool for evaluating the severity of nail psoriasis, nail matrix symptoms such as pitting, leukonychia, crumbling, and red spots have been observed in the lunula. Nail bed symptoms include onycholysis, subungual hyperkeratosis, oil spots, and splinter hemorrhage. However, Beau's lines and nail fold psoriasis, which are not included in this assessment tool, should be considered essential symptoms for indicating the activity of nail psoriasis. Although NAPSI is the most widely used tool for assessing the severity of nail psoriasis, it has uncontrolled limitations. Although other assessment tools have been developed, none have successfully replaced the NAPSI. In clinical trials for nail psoriasis, the NAPSI is used in various forms, such as improvement rates, changes in the mean NAPSI score, and achievement rates of NAPSI 75. Consequently, caution is warranted when interpreting the clinical trial results related to nail psoriasis improvement.

Patient Perspectives of the Impact of Psoriatic Disease on Quality-of-Life in India: Sub-analysis from the Global Psoriasis and Beyond Survey.

Psoriatic disease (PsD), including plaque psoriasis (PsO) and psoriatic arthritis (PsA), comprises a wide spectrum of manifestations and significantly impacts quality-of-life (QoL). Here, we assessed patients' understanding of PsO and PsA as a systemic disease, its impact on their physical and emotional well-being, and patients' experiences with healthcare professionals for shared treatment decision-making. The Global Psoriatic Disease and Beyond Survey was a cross-sectional, qualitative, online survey conducted on patients with moderate-to-severe PsO with/without concomitant PsA. This analysis reports findings from Indian patients. Of the 261 surveyed patients, 27% with PsO reported concomitant PsA, of whom 89% reported PsA severity as moderately or highly active. Overall, 92% had heard the term "PsD," and 90% knew their condition was a systemic disease. Few were aware of PsD manifestations (palmoplantar psoriasis, 49%; nail psoriasis, 43%; axial symptoms, 40%; PsA, 34%) and comorbidities (cardiovascular disease, 33%; obesity, 30%; diabetes, 28%). Eighty-nine percent of patients indicated their skin problems had a "very-large" to "extreme-large" impact on QoL. Ninety-seven percent of patients experienced discrimination and stigmatization from others. Eighty-one percent of patients were not involved in deciding treatment goals. Few (PsO, 6%; PsA, 9%) patients were dissatisfied with current treatment; ≥50% patients reported incomplete relief of skin symptoms (PsO) and joint symptoms (PsA) as the reason for dissatisfaction. Lack of awareness of the manifestations and comorbidities associated with PsD and poor QoL highlights the need for patient education, shared treatment decision-making, and a multidimensional approach to PsD management in India.

Risk Factors Associated with Onychomycosis in Patients Attending Dermatology Units of Some Hospitals in Benue State, Nigeria

Onychomycosis is caused by different organisms especially the genus Trichophyton responsible for fungal nail infection. If left untreated, infection can spread to every nail and over time, the nails become thick, brittle, and ingrown causing pain and discomfort. To investigate the risk factors associated with onychomycosis in patients attending some hospitals within Benue state. A total of 384 finger and toenail samples were collected, disinfected, and subjected to laboratory examination using standard microbiological procedures. Some risk factors for onychomycosis including age, occupation, gender, diabetes mellitus condition, household contacts with animals, use of occlusive footwears, obesity, immune status, family history of onychomycosis, exposure to humid environments among others were investigated using structured questionnaire. The logistic regression for multivariate analysis was further used to identify the relationship between risk factors and onychomycosis. From the 384 samples collected, 226 fungal species were isolated from culture of toeand fingernails samples. Tinea rubrum was identified in159 (70.36%) followed by As per gillusspp., 30 (13.27%), Candida (Yeast), 19 (8.41%), Trichophytoninterdigitale,11 (4.87%) and Epidermophy tonfloc cosum was8 (3.54%). Age was statistically significant toony chomycos is with a positive association (OR=3.06, P=0.02; ≤0.05), while gender (OR=0.85, P=0.45&gt;0.05)and occupation was not statistically significant (OR=1.21, P=0.66; &gt;0.05). Use of occlusive footwear, keeping of long nails, and wearing used shoes showed statistically significant associations with onychomycosis. Individuals who engaged in the afore mentioned risk factors had high odds ratio (39.0, 5.95 and 1.26 respectively). Diabetes mellitus condition, trauma/damage to nails, nail psoriasis, obesity, and immunosuppression also showed statistically significant associations with onychomycosis. Odds ratio was (1.27, 1.86, 4.12, 1.05 and 3.14) respectively. Onychomycosis remains the most common nail disorder with a significant burden. There is need for prevention through practice of good personal hygiene and prescribed treatment of onychomycosis as it can have a considerable impact on patients’ quality of life.

Evaluation of serum selenium level in patients with plaque-type psoriasis

Back ground Psoriasis may be accompanied by homeostatic imbalance of some trace elements such as selenium (Se) that may influence disease management. Se has antiproliferative and immune-modulating properties. There are limited data about the imbalance of Se level in psoriasis patients with equivocal findings. Objective Aim of the study was to evaluate serum Se level in plaque-type psoriasis patients with different severity and chronicity of disease. Patients and methods In this case–control study during 18 months, Se level was analyzed in serum samples of 54 psoriasis patients and 54 healthy volunteers. Se level was measured with atomic absorption method. The extent of psoriasis was investigated using the psoriasis area severity index and nail psoriasis severity index scores. Age, sex, duration of psoriasis, severity scores, and levels of Se were collected and analyzed by SPSS software. Results There was no significant difference in Se levels between two groups (P=0.323). Also median level of Se in patients with different duration time of psoriasis was not significantly different (P=0.157). But there was significant differences in the median level of Se in mild group compared with severe (P=0.035) and moderate group (P=0.018). There was a nonsignificant correlation between severity and duration of psoriasis with Se level. Conclusion Considering these nonsignificant difference, we think that Se imbalance is not probably an important factor in our psoriasis patients.

Role of onychoscopy in diagnosis of psoriatic nail disorders in adults

Role of onychoscopy in diagnosis of psoriatic nail disorders in adults

A Case of Plaque Psoriasis with Nail Psoriasis and Non-specific Pain of Distal Interphalangeal Joint Treated with Guselkumab

A Case of Plaque Psoriasis with Nail Psoriasis and Non-specific Pain of Distal Interphalangeal Joint Treated with Guselkumab

From pathogenesis to current treatment of the cutaneous psoriasis - a literature review

Introduction:&#x0D; Psoriasis is a chronic inflammatory autoimmune disease that can be divided into several subtypes based on the areas of the body occupied by the lesions and the severity of the disease. The overall prevalence of psoriasis ranges from 0 to 11,8%. The disease occurs with equal frequency in both sexes. PsO cannot be completely cured, so many patients experience stigma and have diminished self-esteem due to the characteristic appearance of the lesions.&#x0D; &#x0D; Aim of the study:&#x0D; The purpose of the study is to summarize the available knowledge about classification and options for psoriasis treatment. The options in diagnosis and treatment, including the latest methods, were described and summarized.&#x0D; &#x0D; Materials and methods:&#x0D; Literature available in the PubMed database was reviewed using the following keywords: “Psoriasis”, “Nail Psoriasis”, “Psoriasis Vulgaris”, “Psoriasis Treatment”, “New Psoriasis Treatment”, “Psoriasis Classification”, “Biologic Therapy for Psoriasis”, “Systemic Therapy for psoriasis”.&#x0D; &#x0D; Conclusions: &#x0D; Psoriasis is a genetic skin condition mediated by the immune system. The underlying mechanisms entail intricate interactions between the innate and adaptive immune system. There are various indices for assessing the severity of psoriasis, the most commonly used of which is PASI(Psoriasis Area and Severity Index). Retinoids, cyclosporine and methotrexate are the non-biologic therapies most frequently employed for moderate to severe psoriasis treatment, while topical therapy, which includes mainly corticosteroids and vitamin D analogues, is a successful approach for effectively managing mild psoriasis.

Factors associated with achieving an acceptable health-related quality of life in the treatment of patients with psoriatic arthritis

Objective: to analyze factors associated with the achievement of acceptable health-related quality of life (HRQoL) in patients with psoriatic arthritis (PsA) 7 years after the start of observation.Material and methods. The study included 53 patients (28 women, 25 men) with PsA who met the 2006 CASPAR criteria. The mean age of patients was 45.7±12.0 years, the median duration of PsA was 90 [72; 99] months, and the observation period was 81 [61; 91] months. The study included patients in early stage of PsA (duration up to 2 years), who were treated according to the “treat-to-target” strategy (T2T) for 24 months. Subsequently, all patients continued therapy according to the standards of medical care under the supervision of the treating physician. Over time, a standard rheumatological examination was performed. Activity of PsA was assessed by DAPSA, psoriasis by BSA, HRQoL by Psoriatic Arthritis Impact of Disease (PsAID-12); body mass index (BMI, kg/m2 ) and functional status by HAQ were also assessed. PsAID-12 ≤4 corresponded to achieving a Patient Acceptable State Status (PASS). The results were analyzed in two groups of patients: PsAID-12 ≤4 and PsAID-12 &gt;4. The number of patients (%) who achieved minimal disease activity (MDA) after 1–2 years of active treatment and after 7 years was assessed. X-rays of the hands and feet (n=42) were performed using standard methods, changes were assessed using the Sharp/van der Heijde method modified for PsA (m-Sharp/van der Heijde).Results and discussion. After 7 years, 38 (71.7%) of 53 patients were found to have PASS. Patients who achieved PASS had significantly lower PsA and psoriasis activity, lower CRP levels, lower m-Sharp/van der Heijde scores, better functional status and HRQoL, and lower BMI at baseline. Factors associated with achieving PASS were identified: absence of nail psoriasis, BSA ≤3%, CRP ≤5 mg/l, number of swollen joints ≤3, number of painful joints ≤5, HAQ ≤0.5 at baseline and after 24 months, and achievement of MDA during the first 12 months of treatment.Conclusion. The majority of PsA patients treated at an early stage according to T2T principles had PASS, which is associated with low disease activity, fewer joint erosions, better functional status and achievement of MDA during the first 12 months of therapy. These factors should be considered when predicting disease progression.

Nail psoriasis in China: A prospective multicentre study.

Data on nail psoriasis (PsO) in China are scarce. To provide nail PsO-related data regarding epidemiologic characteristics, manifestations, fungal infections, arthritic complaints and treatments that may facilitate improved patient management globally. From August 2021 to August 2022, patients with nail PsO were enrolled in a prospective multicentre observational study at 25 hospitals in China. We collected and analysed data concerning nail PsO demography, clinical signs, fungal detection, arthritic symptoms and treatment. A total of 817 patients with nail PsO were involved, with a mean body mass index of 24.13 ± 2.93. In addition, 71.41% of the patients were male. The Nail PsO Severity Index score was weakly positively correlated with body surface area. The percentage of nail involvement was 95.29% for fingernails and 57.18% for toenails, with pitting (67.11%) and subungual hyperkeratosis (60.40%) being the most prevalent manifestations, respectively. Toenails showed a significantly higher frequency of nailfold scales, subungual hyperkeratosis and nail plate crumbling and a lower frequency of splinter haemorrhages, pitting and erythema of the lunula. A total of 13.26% of the PsO patients had onychomycosis, and 77.08% were observed in the toenails. Articular symptoms were reported by 12.17% of the patients, with the peripheral type being predominant. Significant associations between articular symptoms and nailfold swelling, subungual hyperkeratosis, nailfold scales, onycholysis and longitudinal ridges were found. Only 2.30% (20 out of 871) of patients with nail PsO received treatment. The most frequently employed therapy for cutaneous PsO with nail involvement was biologic therapy (n = 366). PsO showed distinct manifestations in the toenails and fingernails. Additionally, toenail PsO combined with onychomycosis requires special attention. Articular symptoms in psoriatic patients are associated with specific nail changes. It is important to research and advocate for more potent treatments for nail PsO.

Psoriatic onychodystrophy: Clinical course, diagnosis and therapeutic aspects

Psoriatic onychodystrophy is observed in about 80% of patients with psoriasis. Psoriasis can affect two nail structures ― the matrix and the nail bed.&#x0D; Involvement of the nail matrix in the pathological process can lead to the formation of leukonychia, thimble symptom, red spots in the area of the hole and destruction of the nail plate. On the other hand, the lesion of the nail bed is characterized by the formation of onycholysis, subcutaneous hyperkeratosis and subcutaneous hemorrhages.&#x0D; Nail lesions in psoriasis are accompanied by functional disorders and aesthetic defects, and also indicate a severe course of psoriasis.&#x0D; Treatment of psoriatic onychodystrophy includes topical medications, systemic therapy in cases accompanied by extensive skin lesions.&#x0D; This article is an overview of the main clinical features, diagnostic issues and evaluation methods, as well as treatment options for nail psoriasis.

Predicting Psoriatic Arthritis in Psoriasis Patients - A Swiss Registry Study.

Psoriatic arthritis (PsA) is a prevalent comorbidity among patients with psoriasis, heavily contributing to their burden of disease, usually diagnosed several years after the diagnosis of psoriasis. To investigate the predictability of psoriatic arthritis in patients with psoriasis and to identify important predictors. Data from the Swiss Dermatology Network on Targeted Therapies (SDNTT) involving patients treated for psoriasis were utilized. A combination of gradient-boosted decision trees and mixed models was used to classify patients based on their diagnosis of PsA or its absence. The variables with the highest predictive power were identified. Time to PsA diagnosis was visualized with the Kaplan-Meier method and the relationship between severity of psoriasis and PsA was explored through quantile regression. A diagnosis of psoriatic arthritis was registered at baseline of 407 (29.5%) treatment series. 516 patients had no registration of PsA, 257 patients had PsA at inclusion, and 91 patients were diagnosed with PsA after inclusion. The model's AUROCs was up to 73.7%, and variables with the highest discriminatory power were age, PASI, physical well-being, and severity of nail psoriasis. Among patients who developed PsA after inclusion, significantly more first treatment series were classified in the PsA-group, compared to those with no PsA registration. PASI was significantly correlated with the median burden/severity of PsA (P = .01). Distinguishing between patients with and without PsA based on clinical characteristics is feasible and even predicting future diagnoses of PsA is possible. Patients at higher risk can be identified using important predictors of PsA.