Low psoriatic arthritis prevalence in Asian patients, but much is undiagnosed
MedWire News: Study results confirm a low prevalence of psoriatic arthritis (PsA) among psoriasis patients in Asia, however, they also reveal a high percentage of undiagnosed cases among patients under specialist care.
The Chinese researchers believe it is the role of such specialists to identify and treat patients with PsA.
"Dermatologists should familiarize themselves with the heterogeneous spectrum and clinical manifestations of PsA and other joint disease, which may allow them to recognize PsA with greater sensitivity, to differentiate it from other types of arthritis, and to refer for rheumatology consultation with better specificity," say Furen Zhang (Anhui Medical University, Shandong) and colleagues.
Data from studies concerning the prevalence of PsA is "discordant" they add, with lower figures commonly reported in Asia Europe, North America and South Africa. They therefore carried out a cross-sectional observational study of 1928 Chinese psoriasis patients.
Participants, aged at least 18 years, were asked a series of questions to determine the likelihood of joint involvement in their skin condition. All study participants recorded at least one positive response to eight questions, leading to a suspicion of joint disease.
Study-employed dermatologists then carried out physical analysis of patients' joints and 112 (5.8%) were considered to have PsA. Only nine of these patients had an existing PsA diagnosis, meaning the remaining 103 (92%) PsA cases were new diagnoses.
"A delay in the diagnosis of PsA may result in an erosive arthritis that permanently disables and deforms some individuals with the disease," warn Zhang et al.
Patients with PsA were older (44.9 vs 35.5 years), had a slightly later manifestation of skin lesions (30.8 vs 27.7 years), and had had psoriasis for longer (14.1 vs 7.8 years) than those without PsA. The mean age at onset of PsA was 39.2 years.
"In summary, the results of our study are consistent with a low prevalence of PsA among patients with psoriasis in Asia, and confirm a high percentage of undiagnosed cases," conclude the researchers.
"Dermatologists should pay more attention to the joint symptoms and screen for PsA in their patients, especially those with risk characteristics and early signs," they suggest.
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By Sarah Guy