Reducing the Risk of Developing Psoriatic Arthritis in Patients with Psoriasis

Abstract

Paolo Gisondi,1 Francesco Bellinato,1 Martina Maurelli,1 Davide Geat,1 Alen Zabotti,2 Dennis McGonagle,3 Giampiero Girolomoni1 1Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy; 2Rheumatology Clinic, Department of Medical and Biological Sciences, University Hospital ‘Santa Maria della Misericordia’ c/o University of Udine, Udine, Italy; 3Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UKCorrespondence: Paolo Gisondi, Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, Verona, 37126, Italy, Email [email protected]: Psoriatic arthritis (PsA) is a heterogeneous chronic inflammatory arthritis associated with psoriasis, which may manifest with different domains such as dactylitis, enthesitis, synovitis and spondylitis. The estimated prevalence of PsA in patients with psoriasis ranges widely between 6% and 42%. In most cases, PsA is preceded by skin involvement by an average time of 7– 8 years. In the complex patho-mechanisms involved in the transition from psoriasis to PsA, the gut and skin have been proposed as the sites of immune activation triggering or contributing to the development of PsA. In such a transition, a subclinical phase has been identified, characterized by enthesopathy where soluble biomarkers and imaging findings but no clinical symptoms are detectable. Recent studies have provided some evidence that timely treated psoriasis may reduce the risk of developing PsA.Keywords: psoriatic arthritis, psoriasis, therapy, prevention, early intervention, disease modification

Keywords

• psoriatic arthritis
• psoriasis
• therapy
• prevention
• early intervention
• disease modification