Department of Dermatology, University of Kiel, Kiel, Germany.
J Eur Acad Dermatol Venereol. 2010 May;24(5):548-54. doi: 10.1111/j.1468-3083.2009.03463.x. Epub 2009 Oct 23.
Estimates of psoriatic arthritis (PsA) prevalence among psoriasis patients vary widely (5-40%). The time to development of PsA in patients with plaque psoriasis also remains unclear.
To examine whether length of time since diagnosis of psoriasis affects risk of developing PsA, and to assess differences in quality of life (QoL), work-related issues, comorbidities and healthcare resource utilization (HCRU) for patients with PsA vs. psoriasis.
This large cross-sectional observational study was conducted in the UK, Italy, France, Spain and Germany in 2006. Dermatologists who actively treated patients with psoriasis recruited 10 consecutive patients with psoriasis. Presence of PsA, body surface area (BSA) affected with psoriasis and HCRU were recorded; patients completed EUROQoL (EQ5D) and employment disadvantages questionnaires.
Patients with psoriasis (n = 1560) included 126 with PsA. Ninety per cent of these patients with PsA were seen by dermatologists who involved a rheumatologist in the care of their patients with PsA. Survival analysis indicated that the incidence of PsA among psoriasis patients remained constant (74 per 1000 person-years), while the prevalence increased with time since diagnosis of psoriasis, reaching 20.5% after 30 years. In addition, those with high BSA currently affected by psoriasis were more likely to have developed PsA (P < 0.028). PsA patients reported reduced QoL compared with psoriasis patients (EQ5D score: 0.56 vs. 0.82: P < 0.0005), as well as more work problems. PsA patients were more likely to be hospitalized (0.27 +/- 0.84 vs. 0.14 +/- 0.71 per year; P < 0.0005) and have additional comorbidities than those without PsA.
The incidence of PsA was constant after initial diagnosis of psoriasis, leading to a higher prevalence of concomitant PsA over time. PsA is associated with decreased QoL and increased work-related problems, HCRU and comorbidities. Dermatologists should screen for PsA in their patients, especially long-standing patients who did not initially present with PsA.
银屑病患者中关节炎（PsA）的估计患病率差异很大（5-40%）。斑块状银屑病患者发生 PsA 的时间也尚不清楚。
检查诊断银屑病后的时间长短是否会影响发生 PsA 的风险，并评估患有 PsA 与银屑病的患者之间的生活质量（QoL）、与工作相关的问题、合并症和医疗保健资源利用（HCRU）的差异。
这是一项在英国、意大利、法国、西班牙和德国于 2006 年进行的大型横断面观察性研究。积极治疗银屑病患者的皮肤科医生招募了 10 名连续的银屑病患者。记录了 PsA 的存在、银屑病受累的体表面积（BSA）和 HCRU；患者完成了欧洲五维健康量表（EQ5D）和就业劣势问卷。
银屑病患者（n=1560）包括 126 名患有 PsA 的患者。这些患有 PsA 的患者中有 90%由参与患者 PsA 治疗的风湿病学家的皮肤科医生进行诊治。生存分析表明，银屑病患者中 PsA 的发病率保持不变（每 1000 人年 74 例），而患病率随诊断后时间的增加而增加，30 年后达到 20.5%。此外，目前受高 BSA 影响的银屑病患者更有可能发生 PsA（P<0.028）。与银屑病患者相比，PsA 患者报告的 QoL 降低（EQ5D 评分：0.56 与 0.82；P<0.0005），并且工作问题更多。与没有 PsA 的患者相比，PsA 患者更有可能住院（0.27 +/- 0.84 与 0.14 +/- 0.71 每年；P<0.0005）和有更多的合并症。
银屑病最初诊断后，PsA 的发病率保持不变，导致随着时间的推移，并发 PsA 的患病率更高。PsA 与 QoL 降低以及与工作相关的问题、HCRU 和合并症增加有关。皮肤科医生应在其患者中筛查 PsA，特别是那些最初未出现 PsA 的长期患者。
