Many Patients with Psoriasis May Also Have Undiagnosed Psoriatic Arthritis

Is the prevalence of undiagnosed PsA high enough to recommend dermatologists and other clinicians who treat patients with psoriasis to also screen those patients for psoriatic arthritis?

Should dermatologists and other clinicians who treat patients with psoriasis also screen those patients for psoriatic arthritis (PsA)?

According to the authors of “Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: Systematic review and meta-analysis,” published in the Journal of the American Academy of Dermatology, the prevalence of undiagnosed psoriatic arthritis among patients with psoriasis is high enough to warrant that recommendation.

They noted that psoriasis precedes the onset of psoriatic arthritis in 84% of patients with psoriasis. Early diagnosis and treatment are essential in patients with psoriatic arthritis to avoid long-term joint damage.

To determine the prevalence of undiagnosed psoriatic arthritis in patients with psoriasis, the authors performed a literature search and meta-analysis of the data. Because they found no studies designed to determine the prevalence of undiagnosed psoriatic arthritis in patients with psoriasis, they “assumed that the prevalence of newly diagnosed PsA in patients with psoriasis at the time they seek medical care could be a sound estimate of this value.”

They found 7 epidemiological studies and 5 studies on psoriatic arthritis screening questionnaires, which allowed them to clearly identify patients with newly diagnosed psoriatic arthritis.

Analysis of the data revealed that the prevalence of undiagnosed PsA was 15.5% when all studies were considered and 10.1% when only epidemiological studies were considered.”

The authors noted that this study was conducted using data from studies that were not designed to address the central question of undiagnosed PsA, potentially limiting its usefulness. Still, they concluded that “the high prevalence of undiagnosed PsA in patients with psoriasis adds to the recommendation that dermatologists need to screen all patients with psoriasis for PsA.”