DISCUSSION

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

Discussion: Clinical features, epidemiology, classification criteria, and quality of life in psoriasis and psoriatic arthritis

D D Gladman

Correspondence to:
Correspondence to:
Dr D D Gladman
Toronto Western Research Institute, Psoriatic Arthritis Program, University Health Network, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, 399 Bathurst St. ECW 5-034B, Toronto, Ontario, M5T 2S8, Canada; dafna.gladman@utoronto.ca

Abbreviations: PsA, psoriatic arthritis; RA, rheumatoid arthritis

Keywords: psoriasis; psoriatic arthritis

The first 150 words of the full text of this article appear below.

This is an important issue. It highlights the difficulty in differentiating psoriatic arthritis (PsA) from seronegative rheumatoid arthritis (RA). Generally, the oligoarticular presentation is identified as a feature of PsA, but PsA does evolve from oligoarticular to polyarticular over time. It is just as important to consider the joints involved as the extent of joint involvement. Generally, the differentiation between PsA and RA is more difficult early in the course, before the more classic changes such as pencil in cup are evident. Later in the disease the radiological features are quite helpful. In the future, magnetic resonance imaging (MRI) and ultrasound may provide early clues.

The issue of symmetry has caused confusion in describing the clinical patterns. PsA is considered to be less symmetrical than RA. It clearly tends to be more asymmetrical at presentation due to the oligoarticular onset . . . [Full text of this article]

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