Cui Ran, Chen Miao, Tao Yi-Li, Li Xia, Ding Yang-Feng, Deng Hui, Dai Sheng-Ming
Department of Rheumatology and Immunology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.
Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China.
Clin Rheumatol. 2025 Jun 26. doi: 10.1007/s10067-025-07484-y.
To investigate the diagnostic delay in patients with psoriatic arthritis (PsA) attending dermatology and rheumatology clinics.
Two cohorts of patients with an established diagnosis of PsA from four dermatology clinics and two rheumatology clinics in Shanghai between February 2019 and January 2022 were retrospectively analyzed. Diagnostic delay was defined as the time from the onset of PsA-related musculoskeletal symptoms to PsA diagnosis. Diagnostic delay was compared by sex and arthritis type within each cohort. The cumulative diagnosis rates of PsA in both cohorts were also analyzed.
The dermatology and rheumatology cohorts included 109 and 119 patients with PsA, respectively. The median diagnostic delay was significantly longer in the dermatology cohort than in the rheumatology cohort (median [IQR]: 45.5 [68.3] vs. 16.5 [25.6] months). Within each cohort, there were no significant differences in diagnostic delay between sexes. In the dermatology cohort, patients with pure axial PsA experienced a longer diagnostic delay than those with the peripheral type (median [IQR]: 57 [130] vs. 37 [66] months). Approximately 30% of PsA patients in the dermatology cohort had a diagnostic delay exceeding 6 years. In contrast, in the rheumatology cohort, no patient with PsA experienced a diagnostic delay of more than 5 years, with cumulative diagnosis rates of 39%, 58.5%, 84.8%, 96.7%, and 100% at < 1 year, < 2 years, < 3 years, < 4 years, and < 5 years, respectively.
Patients with PsA attending dermatology clinics experience significantly longer diagnostic delays compared to those attending rheumatology clinics.
调查在皮肤科和风湿科就诊的银屑病关节炎（PsA）患者的诊断延迟情况。
回顾性分析了2019年2月至2022年1月期间来自上海四家皮肤科诊所和两家风湿科诊所的两组已确诊为PsA的患者。诊断延迟定义为从PsA相关肌肉骨骼症状出现到PsA确诊的时间。在每个队列中，按性别和关节炎类型比较诊断延迟情况。还分析了两组中PsA的累积诊断率。
皮肤科队列和风湿科队列分别包括109例和119例PsA患者。皮肤科队列的中位诊断延迟显著长于风湿科队列（中位值[四分位间距]：45.5[68.3]个月 vs. 16.5[25.6]个月）。在每个队列中，性别之间的诊断延迟无显著差异。在皮肤科队列中，单纯轴向型PsA患者的诊断延迟比外周型患者更长（中位值[四分位间距]：57[130]个月 vs. 37[66]个月）。皮肤科队列中约30%的PsA患者诊断延迟超过6年。相比之下，在风湿科队列中，没有PsA患者的诊断延迟超过5年，在<1年、<2年、<3年、<4年和<5年时的累积诊断率分别为39%、58.5%、84.8%、96.7%和100%。
与在风湿科就诊的患者相比，在皮肤科就诊的PsA患者的诊断延迟明显更长。
