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Rheumatology International

, Volume 34, Issue 2, pp 227–234 | Cite as

High prevalence of psoriatic arthritis in dermatological patients with psoriasis: a cross-sectional study

  • Joerg C HenesEmail author
  • Eva Ziupa
  • Michael Eisfelder
  • Annette Adamczyk
  • Bjoern Knaudt
  • Felix Jacobs
  • Juergen Lux
  • Stefan Schanz
  • Gerhard Fierlbeck
  • Daniel Spira
  • Marius Horger
  • Lothar Kanz
  • Ina Koetter
Original Article

Abstract

The exact prevalence of psoriatic arthritis (PsA) among patients with psoriasis is still not conclusive. Data in the literature vary between 5.8 and 30 %. Objective of this study was to gain more information on the prevalence of PsA among patients with psoriasis in Germany. Between 09/2010 and 05/2011, consecutive patients from dermatological private practices and a university hospital with psoriasis were asked to fill out the validated German Psoriatic Arthritis Diagnostic (GEPARD) Questionnaire. Patients who answered ≥4 questions with “yes” were invited to come for a rheumatological check up. Those patients who refused a rheumatological examination were counted as “absence of PsA”. Laboratory tests for inflammatory markers as well as the severity of skin manifestations were assessed. The diagnosis of PsA was made according to the CASPAR criteria, and imaging was performed in addition. A total of 404 questionnaires were evaluated; 50.5 % answered ≥4 questions positively; 19.3 % had a history of PsA confirmed by a rheumatologist; and in 10.9 %, PsA or spondyloarthritis was newly diagnosed during the present study. This leads to an overall prevalence of PsA in patients with psoriasis of 30.2 %. The frequency of psoriatic arthritis in the present study is higher than expected from previous studies in Germany. The prevalence is consistent with findings of a large observational survey from Scandinavia. Using the CASPAR criteria and imaging in all patients, certainty of the diagnosis is very high. The GEPARD Questionnaire is a helpful tool to identify people at risk for psoriatic arthritis.

Keywords

Epidemiology Psoriatic arthritis Psoriasis Prevalence GEPARD Questionnaire 

Notes

Acknowledgments

We also thank Dr. R. Denfeld, Dr. A. Philipp, Dr. P. Ziegler and Dr. M. Kleinhans who also recruited patients for this study, but did not meet the criteria for authorship. This study was supported by an unrestricted grant from Pfizer. The company had no influence on the study protocol, data analysis or conclusions.

Conflict of interest

The authors declare that they have no competing interests.

References

  1. 1.
    Reich K, Krüger K, Mössner R, Augustin M (2009) Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol 160(5):1040–1047PubMedCrossRefGoogle Scholar
  2. 2.
    Salvarani C, Lo Scocco G, Macchioni P, Rossi F, Mantovani W et al (1995) Prevalence of psoriatic arthritis in Italian psoriatic patients. J Rheumatol 22(8):1499–1503PubMedGoogle Scholar
  3. 3.
    Gelfand JM, Gladman DD, Mease PJ, Smith N, Margolis DJ, Nijsten T et al (2005) Epidemiology of psoriatic arthritis in the population of the United States. J Am Acad Dermatol 53(4):573PubMedCrossRefGoogle Scholar
  4. 4.
    Yang Q, Qu L, Tian H, Hu Y, Peng J, Yu X et al. (2011) Prevalence and characteristics of psoriatic arthritis in Chinese patients with psoriasis. J Eur Acad Dermatol Venereol. [epub ahead of print]Google Scholar
  5. 5.
    Radtke MA, Reich K, Blome C, Rustenbach S, Augustin M (2009) Prevalence and clinical features of psoriatic arthritis and joint complaints in 2009 patients with psoriasis: results of a German national survey. J Eur Acad Dermatol Venereol 23(6):683–691PubMedCrossRefGoogle Scholar
  6. 6.
    Zachariae H, Zachariae R, Blomqvist K, Davidsson S, Molin L, Mørk C et al (2002) Quality of life and prevalence of arthritis reported by 5,795 members of the Nordic Psoriasis Associations. Data from the Nordic Quality of Life Study. Acta Derm Venereol 82(2):108–113PubMedCrossRefGoogle Scholar
  7. 7.
    Ibrahim G, Waxman R, Helliwell PS (2009) The prevalence of psoriatic arthritis in people with psoriasis. Arthritis Rheum 61(10):1373–1378PubMedCrossRefGoogle Scholar
  8. 8.
    Gisondi P, Girolomoni G, Sampogna F, Tabolli S, Abeni D (2005) Prevalence of psoriatic arthritis and joint complaints in a large population of Italian patients hospitalised for psoriasis. Eur J Dermatol 15(4):279–283PubMedGoogle Scholar
  9. 9.
    Härle P, Hartung W, Lehmann P, Ehrenstein B, Schneider N, Müller H et al (2010) Detection of psoriasis arthritis with the GEPARD patient questionnaire in a dermatologic outpatient setting. Z Rheumatol 69(2):157–160PubMedCrossRefGoogle Scholar
  10. 10.
    Taylor WJ, Gladman DD, Helliwell PS, Marchesoni A, Mease PJ, Mielants H, CASPAR Study Group (2006) Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 54:2665–2673PubMedCrossRefGoogle Scholar
  11. 11.
    Chandran V, Schentag CT, Gladman DD (2007) Sensitivity of the classification of psoriatic arthritis criteria in early psoriatic arthritis. Arthritis Rheum 57(8):1560–1563PubMedCrossRefGoogle Scholar
  12. 12.
    Fredriksson T, Petterson U (1978) Severe psoriasis: oral therapy with a new retinoid. Dermatologica 157:238–244PubMedCrossRefGoogle Scholar
  13. 13.
    Van Der Heijde DM, Van’t Hof MA, Van Riel PL et al (1990) Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis 49:916–920PubMedCrossRefGoogle Scholar
  14. 14.
    Prevoo ML, Van’t Hof MA, Kuper HH, Van Leeuwen MA, Van de Putte LB, Van Riel PL (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48PubMedCrossRefGoogle Scholar
  15. 15.
    Lukas C, Landewé R, Sieper J et al (2009) Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis 68:18–24PubMedCrossRefGoogle Scholar
  16. 16.
    Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A (1994) Defining spinal mobility in ankylosing spondylitis (AS): the Bath AS Metrology Index. J Rheumatol 21:1694–1698PubMedGoogle Scholar
  17. 17.
    Brandt J, Westhoff G, Rudwaleit M, Listing J, Zink A, Braun J, Sieper J (2003) Validierung einer deutschen Version des Fragebogens zur Messung der Krankheitsaktivität bei ankylosierender Spondylitis. Z Rheumatol 62:264–273PubMedGoogle Scholar
  18. 18.
    Ruof J, Shanga O, Stucki G (1999) Evaluation einer deutschen Version des Bath Ankylosing Spondylitis Functional Index (BASFI) und Dougados Functional Index (DFI). Z Rheumatol 58:218–225PubMedCrossRefGoogle Scholar
  19. 19.
    Spira D, Kötter I, Henes J, Kümmerle-Deschner J, Schulze M, Boss A et al (2010) MRI findings in psoriatic arthritis of the hands. Am J Roentgenol 195(5):1187–1193CrossRefGoogle Scholar
  20. 20.
    Dominguez PL, Husni ME, Holt EW, Tyler S, Qureshi AA (2009) Validity, reliability, and sensitivity-to-change properties of the psoriatic arthritis screening and evaluation questionnaire. Arch Dermatol Res 301(8):573–579PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Husni ME, Meyer KH, Cohen DS, Mody E, Qureshi AA (2007) The PASE Questionnaire: pilot-testing a psoriatic arthritis screening and evaluation tool. J Am Acad Dermatol 57:581–587PubMedCrossRefGoogle Scholar
  22. 22.
    Gladman DD, Schentag CT, Tom BD, Chandran V, Brockbank J, Rosen C et al (2009) Development and initial validation of a screening questionnaire for psoriatic arthritis: the toronto psoriatic arthritis screen (ToPAS). Ann Rheum Dis 68:497–501PubMedCrossRefGoogle Scholar
  23. 23.
    Ibrahim GH, Buch MH, Lawson C, Waxman R, Helliwell PS (2009) Evaluation of an existing screening tool for psoriatic arthritis in people with psoriasis and the development of a new instrument: the Psoriasis Epidemiology Screening Tool (PEST) Questionnaire. Clin Exp Rheumatol 27:469–474PubMedGoogle Scholar
  24. 24.
    Coates LC, Aslam T, Al Balushi F, Burden AD, Burden-Teh E, Caperon AR (2013) Comparison of three screening tools to detect psoriatic arthritis in patients with psoriasis (CONTEST study). Br J Dermatol 168(4):802–807PubMedCrossRefGoogle Scholar
  25. 25.
    Zanoli MD, Wikle JS (1992) Joint complaints in patients with psoriasis. Int J Dermatol 31:488–491CrossRefGoogle Scholar
  26. 26.
    Jones SM, Armas JB, Cohen MG, Lovell CR, Evison G, McHugh NJ (1994) Psoriatic arthritis: outcome of disease subsets and relationship of joint disease to nail and skin disease. Br J Rheumatol 33(9):834–839PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Joerg C Henes
    • 1
    • 2
    Email author
  • Eva Ziupa
    • 1
    • 2
  • Michael Eisfelder
    • 3
  • Annette Adamczyk
    • 4
  • Bjoern Knaudt
    • 4
  • Felix Jacobs
    • 4
  • Juergen Lux
    • 5
  • Stefan Schanz
    • 4
  • Gerhard Fierlbeck
    • 4
  • Daniel Spira
    • 6
  • Marius Horger
    • 6
  • Lothar Kanz
    • 1
    • 2
  • Ina Koetter
    • 1
    • 2
  1. 1.Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-inflammatory Diseases (INDIRA)TuebingenGermany
  2. 2.Department of Internal Medicine II (Hematology, Oncology, Immunology, Rheumatology, Pulmology)University HospitalTuebingenGermany
  3. 3.RottweilGermany
  4. 4.Department of DermatologyUniversity HospitalTuebingenGermany
  5. 5.TuebingenGermany
  6. 6.Department of Interventional and Diagnostic RadiologyUniversity HospitalTuebingenGermany

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