Clinical outcomes and feasibility of the multidisciplinary management of patients with psoriatic arthritis: two-year clinical experience of a dermo-rheumatologic clinic
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Psoriatic arthritis (PsA) is a chronic inflammatory autoimmune arthritis, occurring in patients with psoriasis (Pso), that may affect the whole musculoskeletal system but also nails, eye, and gastrointestinal tract. Dermatologists and rheumatologists usually manage Pso and PsA separately, but early diagnosis and integrated management could achieve better outcomes of both skin and musculoskeletal manifestations, thus improving the health-related quality of life (HRQoL) of patients. In this work, we have described a model of integrated dermo-rheumatologic approach for the early diagnosis of PsA and to present the outcomes of the multidisciplinary management of PsA patients after 48 weeks of follow-up. Pso patients complaining musculoskeletal symptoms were enrolled in a DErmo-Rheumatologic Clinic (DERC) in order to screen, classify, and treat patients with PsA, employing an operative working procedure and a specific flowchart. The integrated dermatologic and rheumatologic management of PsA patients allowed a prompt establishment of the diagnosis and the best therapeutic approach in these patients, with a significant improvement of skin and articular diseases and, eventually, a consistent amelioration of HRQoL. Dermatologists and rheumatologists usually manage the “psoriatic disease” in separated outpatient clinics. In our study, we have demonstrated that a combined DERC, by means of a tight cooperation between the dermatologist and the rheumatologist, which use a specific working procedure and treatment flowchart, may achieve the optimal clinical management of these patients, with a consistent clinical remission of the disease and a significant amelioration of the HRQoL.
KeywordsDermo-rheumatologic clinic (DERC) Health related quality of life psoriatic disease
We are grateful to all the patients included in the DERC that gave their consent to use the data for the scope of this report.
LMM and BD designed the work, performed the clinical examinations, analyzed the data, and wrote the paper, giving equal contribution to the work as first authors; CA designed the work and performed the clinical examinations; ME, CW, CM, CS, DCM performed the clinical examinations; OAM, SF, and GA conceived the work, analyzed the data, and wrote the paper, giving equal contribution as senior authors.
Compliance with ethical standards
Written informed consent was obtained from all the patients.
Ethical approval and consent to participate
This work was conducted in accordance with the ethical principles of the Helsinki Declaration of 1975 and revised in 1983, and in accordance with the ethical standards of the institutional responsible committee on human experimentation.
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