To the Editor:
We have read the letter of Dr. Scarpa1. Our editorial was written as a proposal for a different vision of psoriatic arthritis (PsA), a multifaceted syndrome, in the light of a better treatment stratification, and more in general, personalized medicine2.
In our editorial, we pointed out that PsA, because of its phenotypic complexity, could be better identified and managed as a syndrome, stimulating the reader to think of this condition as a combination of symptoms and signs that together represent a disease process2.
Indeed, we are aware that the pathogenesis, at present, is unique for all manifestations of PsA3 and we did not mention that the term syndrome means different pathogenesis of the various manifestations of PsA.
However, PsA belongs to the group of spondyloarthritis (SpA), a wide spectrum or a constellation of diseases with some common genetic background4,5 and it is potentially a separate disease of this group or a major characteristic of the same disease6.
As a similar condition, Behçet disease has been identified as a syndrome because of its potential complexity, and using this definition can help with disease management7.
Finally, we hope that our proposal to identify PsA as a syndrome could be of some interest, to provide better treatment management toward a target-to-treat strategy8. This is not a step back but a step forward to implement our knowledge and management of PsA.
