Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands.
Acta Derm Venereol. 2023 Apr 27;103:adv5269. doi: 10.2340/actadv.v103.5269.
Patients with psoriasis are at risk of developing psoriatic arthritis, which can lead to joint damage. While screening questionnaires have been developed, their performance varies. The objective of this study was to develop a referral tool for dermatologists to identify psoriasis patients with concomitant psoriatic arthritis for rheumatological referral. This study used data from the DAPPER study, in which psoriasis patients were screened by a rheumatologist for the presence of concomitant psoriatic arthritis. Multivariable regression analysis was used to identify predictive variables for the presence of concomitant psoriatic arthritis: treatment history with conventional systemic drugs (odds ratio (OR) 2.97, 95% confidence interval (95% CI) 1.01-8.74, p = 0.04), treatment history with biologicals/small molecule inhibitors (OR 2.90, 95% CI 1.52-5.53, p = 0.01), patient-reported history of joint pain not caused by trauma (OR 4.23, 95% CI 1.21-14.79, p = 0.01), patient-reported history of swollen joints (OR 4.25, 95% CI 2.17-8.32, p < 0.001), and patient-reported history of sausage-like swollen digits (OR 2.38, 95% CI 1.25-4.55, p = 0.01). Based on these variables, a referral tool was created with an area under the curve of 0.82. This referral tool could be used to aid dermatologists to identify psoriasis patients with concomitant psoriatic arthritis, who may benefit from rheumatological referral.
银屑病患者有发展为银屑病关节炎的风险，这可能导致关节损伤。虽然已经开发出了筛查问卷，但它们的性能各不相同。本研究旨在开发一种皮肤科医生使用的转诊工具，以识别可能需要风湿科转诊的伴发银屑病关节炎的银屑病患者。本研究使用了 DAPPER 研究的数据，该研究中由风湿病学家对银屑病患者进行筛查，以确定是否存在伴发银屑病关节炎。多变量回归分析用于确定伴发银屑病关节炎的预测变量：常规系统药物治疗史（比值比 (OR) 2.97，95%置信区间 (95% CI) 1.01-8.74，p=0.04）、生物制剂/小分子抑制剂治疗史（OR 2.90，95% CI 1.52-5.53，p=0.01）、患者报告的非创伤性关节疼痛史（OR 4.23，95% CI 1.21-14.79，p=0.02）、患者报告的关节肿胀史（OR 4.25，95% CI 2.17-8.32，p<0.001）和患者报告的香肠样肿胀手指史（OR 2.38，95% CI 1.25-4.55，p=0.01）。基于这些变量，创建了一个曲线下面积为 0.82 的转诊工具。该转诊工具可用于帮助皮肤科医生识别伴发银屑病关节炎的银屑病患者，这些患者可能受益于风湿科转诊。
