Extra-articular manifestations in psoriatic arthritis patients

Clin Rheumatol. 2015 Apr;34(4):745-53. doi: 10.1007/s10067-014-2652-9. Epub 2014 May 8.


Psoriatic arthritis (PsA) is an inflammatory rheumatic disorder, associated with skin and/or nail psoriasis. It has been included in the spondyloarthropathies (SpA) group, with which it shares clinical, radiologic, and serologic features and familial and genetic relationship. Inclusion of disease among SpA is also based on their striking points of similarity for extra-articular manifestations (EAMs). The aim of study was to describe the EAMs in patients with PsA, evaluating the prevalence and clinical features associated with established and early PsA. The study was a retrospective analysis of case records of 387 PsA patients. Data recorded were demographic data, disease properties, laboratory tests, drug use, and presence of EAMs. Of 387 PsA patients, 190 have shown EAMs: 33.16 % had bowel involvement, 32.63 % ocular, 28.42 % cardiovascular, 25.79 % urogenital, 8.42 % skin (excluding psoriasis), 1.05 % pulmonary, and 0.53 % renal. A higher prevalence of EAMs was found in axial subset (p < 0.0001) and in established PsA patients (p = 0.03). The disease activity in PsA patients with EAMs was significantly higher (p < 0.0005). Smoker PsA patients had a significantly higher prevalence of EAMs than nonsmoker PsA patients (p < 0.0005). EAMs in PsA patients are common than expected and frequently associated with established form and axial subset. EAMs were more frequent in male gender, and the contemporary presence of male gender and axial subset showed a higher risk to develop EAMs. EAMS were more frequent in patients with a long disease duration and active disease. Moreover, these results suggest that in PsA patients, an initial checkup and a regular screening for EAMs are requested to ensure an appropriate management.

MeSH terms

  • Adult
  • Arthritis, Psoriatic / diagnosis*
  • Cardiovascular Diseases / diagnosis
  • Eye Diseases / diagnosis
  • Female
  • Humans
  • Inflammation / diagnosis
  • Intestinal Diseases / diagnosis
  • Lung Diseases / diagnosis
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Rheumatic Diseases / diagnosis*
  • Sex Factors
  • Skin Diseases / diagnosis
  • Treatment Outcome
  • Urologic Diseases / diagnosis