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Psoriatic arthritis and psoriasis: classification, clinical features, pathophysiology, immunology, genetics

Psoriatic arthritis: epidemiology, clinical features, course, and outcome

D D Gladman¹, C Antoni², P Mease³, D O Clegg⁴, P Nash⁵

¹ University of Toronto, Toronto Western Research Institute, Psoriatic Arthritis Program, University Health Network, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada
² Department of Medicine-3, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
³ Seattle Rheumatology Associates; Rheumatology Clinical Research, Swedish Hospital Medical Center; University of Washington School of Medicine, Seattle, WA, USA
⁴ Rheumatology Section, Salt Lake City Veterans Health Care System, University of Utah School of Medicine, Salt Lake City, Utah, USA
⁵ Rheumatology Research Unit, Nambour Hospital, Sunshine Coast; and Department of Medicine, University of Queensland, Queensland, Australia

Correspondence to:
Correspondence to:
Dr D Gladman
Toronto Western Hospital, 399 Bathurst St ECW 5-034B, Toronto, Ontario, M5T 2S8, Canada; dafna.gladman{at}utoronto.ca

Psoriatic arthritis (PsA) has been defined as a unique inflammatory arthritis associated with psoriasis. Its exact prevalence is unknown, but estimates vary from 0.3% to 1% of the population. The clinical features described initially are recognised by most experienced clinicians, although they are most distinct in early disease. Initially, PsA typically presents as an oligoarticular and mild disease. However, with time PsA becomes polyarticular, and it is a severe disease in at least 20% of patients. Patients with PsA who present with polyarticular disease are at risk for disease progression. In addition to progression of clinical and radiological damage, health related quality of life is reduced among patients with PsA. It important to note that patients included in recent drug trials resemble patients followed prospectively in a clinic.

Abbreviations: PsA, psoriatic arthritis; RA, rheumatoid arthritis

Keywords: psoriatic arthritis; clinical features; epidemiology; outcome; prognosis

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