A recent study identified a number of clinical and genetic features that could help stratify patients with psoriasis who are at higher risk for having psoriatic arthritis (PsA) and for whom rheumatology referral may be beneficial. Researchers analyzed a cohort of 974 patients with psoriasis at an academic medical center, of whom 175 had confirmed PsA, and performed univariate, multivariate, and predictive modeling to determine factors associated with PsA. They found:
- The univariate analysis revealed significant positive associations of PsA with age, nail involvement, scalp involvement, skin fold involvement, elbow/knee involvement, psoriasis severity, plaque subtype, erythrodermic subtype, hypertension, type 2 diabetes, and coronary artery disease.
- There was a significant negative association of PsA with the human leukocyte antigen (HLA)-C*06:02 allele.
- In the multivariate analysis, nail involvement, type 2 diabetes, and pustular psoriasis remained significantly associated with PsA, while HLA-C*06:02 positivity remained protective.
- There was a trend towards an association of PsA with older age, younger age of psoriasis onset, and skin fold involvement, while there was protective trend for smoking.
Yan D, Ahn R, Leslie S, Liao W. Clinical and genetic risk factors associated with psoriatic arthritis among patients with psoriasis. [Published online ahead of print October 20, 2018]. Dermatol Ther (Heidelb). doi:10.1007/s13555-018-0266-x.