PT  - JOURNAL ARTICLE
AU  - Roberto Ranza
AU  - Sueli Carneiro
AU  - Abrar A.  Qureshi
AU  - Gladys Martins
AU  - Jose Joaquim  Rodrigues
AU  - Ricardo Romiti
AU  - Thiago Bitar M.  Barros
AU  - Jamille Carneiro
AU  - Ana Luisa  Sampaio
AU  - Rachel Grynszpan
AU  - Juliana Markus
AU  - Rogerio Melo Costa  Pinto
AU  - Claudia Goldenstein-Schainberg
TI  - Prevalence of Psoriatic Arthritis in a Large Cohort of Brazilian Patients with Psoriasis
AID  - 10.3899/jrheum.140474
DP  - 2015 Mar 01
TA  - The Journal of Rheumatology
PG  - jrheum.140474
4099  - http://www.jrheum.org/content/early/2015/02/24/jrheum.140474.short
4100  - http://www.jrheum.org/content/early/2015/02/24/jrheum.140474.full
AB  - Objective To determine the prevalence of psoriatic arthritis (PsA) in a large cohort of Brazilian patients with psoriasis (PsO) being seen at dermatology centers. Methods A multicenter study was conducted in 4 university dermatology clinics. In each center, consecutive patients with confirmed diagnoses of PsO were evaluated by a rheumatologist. Individuals were classified as having PsA according to the ClASsification criteria for Psoriatic ARthritis (CASPAR). Laboratory tests and radiographs were performed, as needed, based on the clinical judgment of the rheumatologist. Results A total of 524 patients with PsO were evaluated. The mean age was 48.5 ± 14.5 years, 50% were women, and the mean PsO duration was 15.4 ± 11.7 years. A diagnosis of PsA was documented in 175 patients (33%), of whom 49% were newly identified by the rheumatologist. Most individuals with PsA (72%) had peripheral involvement, 11% had isolated axial involvement, and 17% had both peripheral and axial involvement. Dactylitis occurred in 20% and clinical enthesitis in 30% of the patients. Laboratory and/or radiograph tests were necessary for a definitive diagnosis of PsA in 42 of 175 individuals (24%). Conclusion In our study, one-third of Brazilian patients with PsO, followed in dermatology settings, were diagnosed with PsA by a rheumatologist. Almost half of subjects with PsA had no previous diagnosis. A collaboration between dermatologists and rheumatologists is greatly needed to establish earlier PsA diagnoses and adequate multidisciplinary management.