Mount Sinai-Beth Israel Hospital, Icahn School of Medicine at Mount Sina, New York, NY, USA.
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
J Dermatolog Treat. 2022 Jun;33(4):1907-1915. doi: 10.1080/09546634.2021.1942423. Epub 2021 Jun 28.
Psoriasis is a chronic, immune-mediated disease that includes a broad spectrum of systemic manifestations, complications, and comorbidities. Approximately 20%-30% of patients with psoriasis eventually develop psoriatic arthritis, and up to half of those without psoriatic arthritis experience subclinical musculoskeletal abnormalities. Recognition of early musculoskeletal inflammatory signs in patients with psoriasis is important to understand the extent and severity of this systemic disease, assess the risk of structural joint damage, and ensure timely and effective treatment of the complete spectrum of psoriatic disease. Delayed or ineffective treatment can lead to decreased quality of life, irreversible musculoskeletal damage, and loss of function. In this review, we highlight features of subclinical or early psoriatic arthritis among patients with psoriasis of which dermatologists should be aware. Recent knowledge of features of preclinical psoriatic arthritis in patients with psoriasis is presented. We briefly discuss important risk factors, clinical features, and other characteristics of patients likely to progress from psoriasis to psoriatic arthritis that should be known by dermatologists. Screening tools commonly used in the dermatology clinic to detect psoriatic arthritis are also critically reviewed. Finally, we provide expert commentary for dermatologists concerning the treatment of patients with psoriasis and subclinical signs of early psoriatic arthritis.
银屑病是一种慢性、免疫介导的疾病，包括广泛的全身表现、并发症和合并症。大约 20%-30%的银屑病患者最终会发展为银屑病关节炎，而多达一半没有银屑病关节炎的患者会出现亚临床肌肉骨骼异常。认识到银屑病患者早期肌肉骨骼炎症迹象对于了解这种全身性疾病的程度和严重程度、评估结构关节损伤的风险以及确保及时有效的治疗银屑病的完整谱系非常重要。治疗延迟或无效可能导致生活质量下降、不可逆的肌肉骨骼损伤和功能丧失。在这篇综述中，我们强调了皮肤科医生应该注意的银屑病患者亚临床或早期银屑病关节炎的特征。介绍了银屑病患者临床前银屑病关节炎的最新特征。我们简要讨论了可能从银屑病进展为银屑病关节炎的患者的重要危险因素、临床特征和其他特征，皮肤科医生应该了解这些特征。还对皮肤科诊所常用的筛查工具进行了批判性审查。最后，我们为皮肤科医生提供了有关治疗银屑病和早期银屑病关节炎亚临床迹象患者的专家意见。
