Erasmus University Medical Centre, Rotterdam, The Netherlands.
Erasmus University Medical Centre and Maasstad Hospital, Rotterdam, The Netherlands.
Arthritis Rheumatol. 2016 Apr;68(4):924-31. doi: 10.1002/art.39530.
To estimate the prevalence of psoriatic arthritis (PsA) in primary care patients diagnosed as having psoriasis and to estimate the prevalence of musculoskeletal symptoms in psoriasis patients in primary care.
We conducted a cross-sectional study in adult primary care patients with psoriasis. Responding patients reporting pain in joints, entheses, or the lower back were interviewed by telephone to determine eligibility and, if eligible, were invited for clinical evaluation. During clinical evaluation, skin, nails, joints, and entheses were assessed. Additionally, ultrasound of the enthesis was performed by an independent trained examiner if a patient had at least 1 tender enthesis (determined by the Leeds Enthesitis Index and the Maastricht Ankylosing Spondylitis Enthesitis Score). Patients who fulfilled the Classification of Psoriatic Arthritis (CASPAR) Study Group criteria were classified as having PsA.
We invited 2,564 psoriasis patients from databases of 97 participating general practitioners. Of 1,673 responders (65.2%), 841 (50.3%) were willing to participate. A total of 823 patients (32.1%) reported having musculoskeletal symptoms; 659 of these patients were determined to be eligible, 524 of whom were clinically evaluated. We identified 64 cases of established PsA and another 17 cases of newly diagnosed PsA, leading to a prevalence of 3.2% (95% confidence interval [95% CI] 2.5-3.9) among psoriasis patients in primary care. This prevalence would increase to 4.6% (95% CI 3.8-5.4) if PsA cases based on enthesitis were also taken into account.
Among psoriasis patients in primary care, the prevalence of PsA is conservatively estimated to be 3.2%, increasing to 4.6% if enthesitis is taken into account. The prevalence of musculoskeletal symptoms among psoriasis patients is comparable with the prevalence of musculoskeletal symptoms in the general population.
评估在初级保健中被诊断为患有银屑病的患者中，患有银屑病关节炎（PsA）的患病率，并评估初级保健中患有银屑病的患者中肌肉骨骼症状的患病率。
我们对成年初级保健中的银屑病患者进行了横断面研究。报告关节、附着点或下背部疼痛的应答患者通过电话进行访谈以确定是否符合入选标准，如果符合入选标准，则邀请他们进行临床评估。在临床评估期间，评估皮肤、指甲、关节和附着点。此外，如果患者至少有 1 个压痛附着点（由利兹附着点炎指数和马斯特里赫特强直性脊柱炎附着点炎评分确定），则由一位独立的经过培训的检查者对附着点进行超声检查。符合银屑病关节炎分类（CASPAR）研究组标准的患者被归类为患有 PsA。
我们从 97 名参与的全科医生数据库中邀请了 2564 名银屑病患者。在 1673 名应答者（65.2%）中，有 841 名（50.3%）愿意参加。共有 823 名（32.1%）患者报告有肌肉骨骼症状；其中 659 名患者符合入选标准，524 名患者进行了临床评估。我们发现了 64 例已确诊的 PsA 和另外 17 例新诊断的 PsA，导致初级保健中银屑病患者的患病率为 3.2%（95%置信区间[95%CI]2.5-3.9）。如果还考虑到附着点炎的病例，这一患病率将增加到 4.6%（95%CI 3.8-5.4）。
在初级保健中的银屑病患者中，保守估计 PsA 的患病率为 3.2%，如果考虑到附着点炎，则增加到 4.6%。银屑病患者肌肉骨骼症状的患病率与普通人群中肌肉骨骼症状的患病率相当。
