American Journal of Clinical Dermatology

, Volume 14, Issue 5, pp 377–388 | Cite as

Burden of Disease: Psoriasis and Psoriatic Arthritis

  • Wolf-Henning BoehnckeEmail author
  • Alan Menter
Review Article


Psoriatic arthritis (PsA) increases the disease burden associated with psoriasis by further diminishing quality of life, increasing health care costs and cardiovascular risk, and potentially causing progressive joint damage. The presence of PsA influences psoriasis treatment by increasing overall disease complexity and, within the framework of current guidelines and recommendations, requiring the use of conventional disease-modifying anti-rheumatic drugs or tumor necrosis factor-α inhibitors in order to prevent progressive joint damage. Despite its important impact, PsA is still under-diagnosed in dermatology practice. Dermatologists are well positioned to recognize and treat PsA, given that it characteristically presents, on average, 10 years subsequent to the appearance of skin symptoms. Regular screening of psoriasis patients for early evident joint symptoms should be incorporated into daily dermatologic practice. Although drugs effective in PsA are available, not all patients may respond to treatment, and others may lose their initial response over time. New investigational therapies, such as inhibitors of interleukin-17A, interleukin-12/23, Janus kinase 3, or phosphodiesterase-4, may address unmet needs in psoriatic disease, with further research needed to determine the role of these agents in reducing joint damage and other comorbidities.


Psoriasis Psoriatic Arthritis Psoriasis Patient Ustekinumab Dermatology Life Quality Index 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Novartis supported this manuscript with an unrestricted writing grant.

Dr Boehncke reports having received honoraria as an advisor or speaker for Abbott, Amgen, Biogen Idec, Janssen, Lilly, MSD, Novartis, and Pfizer and research grants from Janssen and Pfizer. Dr Menter reports having received honoraria as an advisor, investigator, or speaker for Abbott, Allergan, Amgen, Celgene, Galderma, Janssen, LEO Pharma, Lilly, Novartis, Novo Nordisk, Pfizer, Stiefel Laboratories, Syntrix Biosystems, and Wyeth; and research grants from Abbott, Allergan, Amgen, Celgene, Janssen, Lilly, Novartis, Novo Nordisk, Pfizer, Stiefel Laboratories, and Syntrix Biosystems.

Drs Boehncke and Menter had full access to all papers cited in this article and take responsibility for the accuracy of the data analysis. Both authors were responsible for the analysis and interpretation of data reported in this article and in revising the manuscript for important intellectual content. Both approved the final submitted version.

The authors are indebted to Kathryn Miles and Andrew Horgan of BioScience Communications, New York, NY, for help in literature searches and in preparing the draft of this manuscript, activities that were supported by Novartis.


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Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  1. 1.Service de dermatologieHôpital Universitaire de GenèveGeneva 14Switzerland
  2. 2.Department of DermatologyBaylor University Medical CenterDallasUSA

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