Garcia-Salinas Rodrigo, Magri Sebastian, Mareco Jonatan, Jaldin Rosario, Perez Ronald, Ruta Santiago, Baraliakos Xenofon
Rheumatology Unit, Hospital Italiano de La Plata-Universidad Nacional de La Plata, La Plata, Argentina.
Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Bochum, Germany.
Rheumatology (Oxford). 2025 May 1;64(5):2550-2556. doi: 10.1093/rheumatology/keae562.
Referral of patients from dermatology to rheumatology practices due to psoriasis is unnecessary delayed. Many times musculoskeletal symptoms are the first reason for consultation. We aimed to estimate the proportion of ARP-PsA (arthralgia with risk to progression) defined by patients with arthralgia and the presence of psoriasis and/or a family history. Also, identify clinical, laboratory and imaging prognostic factors of PsA progression within the ARP-PsA group over a one year follow-up period.
Patients were included in a comprehensive arthralgia evaluation program, with the ARP-PsA criteria defined as arthralgia with Pso and/or a family history of Pso, not referred from dermatology. Baseline characteristics were analysed, and the progression to PsA at one year was assessed. Multivariate analysis identified predictor features for progression.
Of the 1419 patients, 8.4% met ARP-PsA criteria, and 29% of this subgroup developed PsA at one year. Baseline differences between those who developed PsA and those who did not included family history, Pso duration, pain severity, joint count and imaging findings (X-ray and ultrasound). Multivariate analysis revealed the predictive significance of a combination of Pso plus family history of psoriasis disease, synovitis by Power Doppler ultrasound, ultrasound enthesopathy findings and low tender joint count.
The frequency of patients ARP-PsA was 8.4%, of whom 29% developed PsA at one year. The main predictor variables for this progression were identified.
因银屑病而将患者从皮肤科转诊至风湿病科的过程不必要地延迟了。很多时候，肌肉骨骼症状是患者前来就诊的首要原因。我们旨在评估由关节痛患者以及银屑病和/或家族史的存在所定义的进展性关节炎风险伴银屑病（ARP-PsA）的比例。同时，确定在一年随访期内ARP-PsA组中银屑病关节炎（PsA）进展的临床、实验室和影像学预后因素。
患者纳入一项全面的关节痛评估项目，ARP-PsA标准定义为伴有银屑病（Pso）和/或银屑病家族史的关节痛，且非皮肤科转诊患者。分析基线特征，并评估一年时进展为PsA的情况。多变量分析确定进展的预测特征。
在1419例患者中，8.4%符合ARP-PsA标准，该亚组中29%在一年时发展为PsA。发展为PsA的患者与未发展为PsA的患者之间的基线差异包括家族史、银屑病病程、疼痛严重程度、关节计数和影像学表现（X线和超声）。多变量分析显示，银屑病加银屑病家族史、能量多普勒超声显示的滑膜炎、超声附着点病表现以及低压痛关节计数的组合具有预测意义。
ARP-PsA患者的频率为8.4%，其中29%在一年时发展为PsA。确定了这一进展的主要预测变量。
