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在专门的银屑病疾病分诊诊所中,无论转诊途径如何,新的银屑病关节炎诊断率相似。

Similar rates of new psoriatic arthritis diagnoses in a dedicated psoriatic disease triage clinic, regardless of referral route.

作者信息

Meridor Katya, Harrison Stephanie R, De Marco Gabriele, Shams Kave, Laws Philip M, Helliwell Philip S, McGonagle Dennis, Marzo-Ortega Helena, Freeston Jane E

机构信息

NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK.

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.

出版信息

Rheumatol Adv Pract. 2025 Jul 25;9(3):rkaf091. doi: 10.1093/rap/rkaf091. eCollection 2025.

Abstract

OBJECTIVES

To describe the findings from a dedicated psoriatic disease (PsD) triage clinic, including new PsA diagnosis rates, the characteristics of psoriasis (PsO) patients referred by general practitioners (GPs) dermatologists and the utility of the Psoriasis Epidemiology Screening Tool (PEST).

METHODS

A single-centre, cross-sectional study of consecutive PsO patients with arthralgia referred by either GPs or dermatologists to the PsD Triage Clinic underwent clinical, laboratory and imaging evaluations as appropriate. Patient characteristics were compared by referral route and by PEST scores using a Wilcoxon signed-rank test for continuous variables and a chi-squared test for categorical variables.

RESULTS

Of 158 patients [mean age 49 years (s.d. 14), 63% female], 28% were diagnosed with PsA, with similar rates across referral sources. Dermatology-referred patients had more metabolic comorbidities and more DMARD exposure ( < 0.05), whereas GP-referred patients were more often female and had a family history of PsA ( < 0.05). Overall, PEST demonstrated limited sensitivity (56.8%) and specificity (41.4%) for PsA. Patients with a PEST score ≥3 were older, had higher BMI and more entheseal tenderness than those with a PEST score <3.

CONCLUSIONS

A PsD triage clinic facilitated early PsA diagnosis in nearly one-third of referred patients, irrespective of GP or dermatology clinic referral routes.

摘要

目的

描述一家专门的银屑病疾病(PsD)分诊诊所的研究结果,包括新的银屑病关节炎(PsA)诊断率、全科医生(GP)和皮肤科医生转诊的银屑病(PsO)患者的特征以及银屑病流行病学筛查工具(PEST)的效用。

方法

一项单中心横断面研究,连续纳入由全科医生或皮肤科医生转诊至PsD分诊诊所的伴有关节痛的PsO患者,进行适当的临床、实验室和影像学评估。使用Wilcoxon符号秩检验比较连续变量的患者特征,并使用卡方检验比较分类变量的患者特征,比较转诊途径和PEST评分。

结果

158例患者[平均年龄49岁(标准差14),63%为女性]中,28%被诊断为PsA,各转诊来源的诊断率相似。皮肤科转诊的患者有更多的代谢合并症和更多的疾病改善抗风湿药物(DMARD)暴露(P<0.05),而全科医生转诊的患者女性更多且有PsA家族史(P<0.05)。总体而言,PEST对PsA的敏感性(56.8%)和特异性(

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