Background Psoriatic arthritis (PsA) is a disease with musculoskeletal and skin inflammation (psoriasis). Attempts are being made to develop comprehensive disease measures to capture global disease activity. However very little is known on how much psoriasis actually affects quality of life (QOL) in patients with PsA.
Objectives In this study we aim to determine to what extent psoriasis affects quality of life in incident Psoriatic Arthritis patients.
Methods Data collected at baseline in the Dutch south west Psoriatic Arthritis Registry (DEPAR) study were used. The DEPAR includes newly diagnosed PsA patients from 8 hospitals in the South-West of the Netherlands. PsA core measurements were collected: Swollen and Tender join count (66/68), enthesitis (LEI and MASES), dactylitis (LDI) and psoriasis (PASI). In addition 3 patient reported measures of quality of life were administered. Short Form-36 (SF-36) is a self-administered 36-item health survey questionnaire. The items are assigned to eight scales grouped in two factors: physical component summary (PCS) and mental component summary (MCS, score 0–100). Skindex-17 is a self-administered 17-item dermatology questionnaire that explores functioning, emotions and symptoms in a Symptoms Subscale (SS; range 0–10) and a Psychosocial Subscale (PS; range 0–24).The DLQI is a self-administered 10-item questionnaire, score 0–30 with higher scores resulting in poorer quality of life. It covers Symptoms and feelings, Daily activities, Leisure, Work and school, Personal relationships and Treatment
Results In total 281 patients were included: mean age was 50.6 (SD 13.6) and 50.5% were male. In terms of arthritis subtypes, 56 (20%) had mono-arthritis, 108 (39%) oligo-arthritis, 80 (29%) poly-arthritis and 35 (12%) were diagnosed with axial disease, dactylitis or enthesitis only. The Median PASI score was 2.3, ranging from 0 to 22.5. Divided in PASI categories (1) this resulted for 12% in no skin disease, 72% mild (>0–7), 11% moderate (7–12) and 5% had severe (>12) psoriasis. Median PASI scores were different for mono, oligo to polyarthritis group: 2.7 (0–12.3), 3.4 (0–22.5) and 4.4 (0–21). Skin related quality of life measured by DLQI showed a median 1 (QR 0–5) and the two subscales of the skindex resulted in a median SS 4 (IQR 2–6) and a PS of 2 (IQR 0–8), and a SF-36 PCS of 40.3 (8.3) and SF-36 MCS of 47.7 (10.4).(table 1) Comparing none and mild psoriasis to moderate and sever psoriasis resulted in median scores for DLQI: 1 vs 5 (p<0.01) and Skindex-17 SS: 4 vs 7 and skindex-17 PS: 2 vs 7 (p<0.01)while significant difference was observed for the bodily pain an emotional role subscales of the SF-36. (P<0.05)
Conclusions Skin involvement in incident Psoriatic Arthritis is in the majority of patients mild with median PASI score of 2.3. About 15% suffered from moderate to severe psoriasis. Skin quality of life measures showed poorer health states for these patients, which was also reflected in the emotional role and bodily pain subscale of more generic QOL questionnaire: SF-36.
Disclosure of Interest None declared