Clinical Edge

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Psoriasis Linked with Two Foot/Ankle Conditions

RMD Open; 2018 May 21; Lewinson, et al

Patients with psoriasis can have foot and ankle tendinopathy or enthesopathy without having psoriatic arthritis, presenting a diagnostic challenge to physicians, a recent study found. Patients with cutaneous psoriasis and a general population cohort were identified in The Health Improvement Network, a general practice medical records database. All patients with psoriatic arthritis were excluded. Cox proportional-hazards models (α=0.05) estimated the hazard ratio (HR) for development of foot and ankle tendinopathy or enthesopathy among patients with psoriasis, with adjustment for numerous covariates. Researchers found:

  • In total, 78,630 patients with cutaneous psoriasis and 5,983,338 persons from the general population were identified.
  • In an unadjusted model, patients with cutaneous psoriasis had a 25% increased risk of developing foot and ankle tendinopathy or enthesopathy compared with the general population (HR 1.25).
  • The HR remained unchanged and statistically significant after adjusting for covariates, and in sensitivity analyses.


Lewinson RT, Vallerand IA, Parsons LM, et al. Psoriasis and the risk of foot and ankle tendinopathy or enthesopathy in the absence of psoriatic arthritis: A population-based study. RMD Open. 2018;4(1):e000668. doi:10.1136/rmdopen-2018-000668.