“It is necessary for the dermatologist to ask the patient with psoriasis if he has pain in the joints, because with this simple question, the specialist is able to intercept the presence of psoriatic arthritis and sensitize the patient to pay attention to the main symptoms of the disease“So Claudia Giofrè, dermatologist and responsible for psoriasis at the Papardo hospital in Messina, in an editorial published by Aleati per la Salute (www.alleatiperlasalute.it), the portal dedicated to medical-scientific information created by Novartis.
“During the visit – writes Giofrè – the dermatologist captures some aspects of the patient’s psoriasis, including nail involvement (psoriatic onychopathy), scalp, palm-plantar, which are strongly evocative of a possible joint involvement. this, the dermatologist can play a sentinel role, able to reveal quite early pictures of psoriatic arthritis “.
Psoriatic arthritis (PSA) is an inflammatory arthritis that affects up to one third of patients with psoriasis. “Clinically – Giofrè explains – PSA is characterized by an insidious onset. Most of the data currently available on early psoriatic arthritis (Epsa) derives from studies conducted in the rheumatology field. However, in recent years, there has been an increase the amount of data from dermatological centers. A diagnosis of Epsa can be performed correctly in a dermatological clinic. To do so, however, close collaboration between dermatologists, rheumatologists and radiologists is necessary, as shown by an Italian study that considered all patients with psoriasis who visited the center from January 2007 to May 2010, and were asked if there were symptoms of joint inflammation. Patients who had had joint pain for a year were diagnosed, based on laboratory results and imaging (ultrasonography), an early psoriatic arthritis. In 66% of patients who received the diagnosis of Epsa, the inflammation involved alm eno 5 joints. Even in the absence of evidence of joint damage, ultrasound and contrast ultrasound showed signs of joint inflammation in all patients. ”
Chronic inflammatory autoimmune disease affects patients with psoriasis and can affect the entire musculoskeletal system as well as the nails, eyes and gastrointestinal tract. “Dermatologists and rheumatologists – underlines Giofrè – usually manage the two diseases separately, but early diagnosis and integrated management, as recent studies show, could obtain better results both in terms of skin and musculoskeletal manifestations, thus improving the quality of the life related to the health of patients “.
The full editorial is available on: https://www.alleatiperlasalute.it/diagnosi/psoriasi-il-dermatologo-sentinella
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