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AB0782 Psoriatic arthritis early ultrasonographic changes in patients with psoriasis and nail psoriasis. a comparative study with subjects without psoriasis
  1. P Rodriguez Henriquez1,
  2. ML Cardenas-Hernandez2,
  3. L Lammoglia-Ordiales2,
  4. LT Becerril-Mendoza3,
  5. RM Lacy-Niebla2
  1. 1Rheumatology
  2. 2Dermatology, Hospital General Dr. Manuel Gea González
  3. 3Rheumatology, Hospital Juarez de Mexico, Mexico, Mexico

Abstract

Background Psoriatic Arthritis (PsA) has a prevalence of 30% amongst Psoriasis (Ps)patients. However in patients with ungueal Ps the prevalence has been reported in up to 68% of cases. In muskuloskeletal ultrasound (MSUS) studies the lesion most frequently reported is enthesitis followed by synovitis in early PsA patients.

Objectives To determine the presence of psoriatic arthritis early ultrasonographic changes in patients with psoriasis, nail psoriasis, and subjects without psoriasis.

Methods Analytic, comparative, prospective and transversal study, in which patients with psoriasis, nail psoriasis, and subjects without psoriasis paired by age, were recruited. Each group underwent a skin and joint checkup, which included demographic data, comorbidities, psoriasis severity and joint signs and symptoms. The ultrasonographic evaluation consisted in a gray scale detection and classification according to severity scales, of synovitis, enthesitis, synovial effusion and bone erosions in the distal interphalangeal joints of both hands.

Results A total of 16 patients, 8 with psoriasis and 8 with nail psoriasis, as well as 9 subjects without psoriasis, were recruited. The psoriasis group included mostly men (87.5%), unlike the subjects without psoriasis (44.4%) and the nail psoriasis group (37.5%) (p=0.09). The mean age for the study population was 55.16 + 8.09 years. There was no statistical significance between groups (p=0.430). The greatest prevalence of comorbidities was found in both groups with psoriasis. The mean time of disease duration in the nail psoriasis group was 20.12 + 14.54 years, vs 13.37 + 14.45 years in the psoriasis group (p=0.247). Synovitis was found in 100% of patients in the psoriasis group, vs 37.5% in the nail psoriasis group, and 62.5% in the subjects without psoriasis group (p=0.028). No enthesitis was observed in any group

Conclusions Synovitis was more frequent than enthesitis in our population as an ultrasonographic finding of psoriatic arthritis. No association was found between other variables with synovitis, such as age, sex, disease duration and comorbidities.

References

  1. Raposo I, Torres T. Nail psoriasis as a predictor of the development of psoriatic arthritis. Actas Dermosifiliogr 2015;106(6):452–457.

  2. Busse K, Liao W. Which Psoriasis Patients Develop Psoriatic Arthritis? Psoriasis Forum 2010;16(4):17–25.

  3. Gladman DD, Antoni C, Mease P, Clegg DO, Nash P. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis 2005;64(2):ii14-ii17.

  4. Ibrahim G, Waxman R, Helliwell PS. The Prevalence of Psoriatic Arthritis in People With Psoriasis. Arthritis & Rheumatism (Arthritis Care & Research) 2009;61(10):1373–1378.

  5. Naredo E, Möller I, De Miguel E, et al. High prevalence of ultrasonographic synovitis and enthesopathy in patients with psoriasis without psoriatic arthritis: a prospective case-control study. Rheumatology (Oxford) 2011;50 (10):1838–1848.

References

Disclosure of Interest None declared

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