Screening of psoriatic arthritis by dermatologists - a German nationwide survey

J Dtsch Dermatol Ges. 2024 Nov;22(11):1509-1516. doi: 10.1111/ddg.15486. Epub 2024 Sep 20.

Abstract

Background and objectives: Up to 30% of psoriasis (PsO) is clinically associated with psoriatic arthritis (PsA). A large proportion of new onset of PsA is diagnosed at a later stage, despite the necessity of early effective treatment to prevent structural damage. This study aimed to identify the routine screening practices used for PsA in patients with PsO.

Patients and methods: This non-interventional, prospective, epidemiological, cross-sectional study conducted in Germany focuses on screening activity and treatment selection of dermatological practices in suspected PsA. Descriptive statistics and patient characteristics were analyzed for different center types.

Results: One hundred ninety-five patients from 34 office-based physicians, five non-university hospitals, and nine university hospitals were included. Questionnaires or imaging techniques were not routinely used (< 45%). Especially, ultrasounds (≤ 5%) and MRIs (< 6.3%) were rarely performed. Between 30% and 75% of suspected PsA could be confirmed. Referral to rheumatologists and/or appropriate therapy initiation were the most frequent consequences.

Conclusions: Results of this study reflect the status of PsA screening activity by dermatologists. Imaging techniques, particularly ultrasound or MRIs to detect early forms of PsA, were inadequately used, which may have contributed to continued underdiagnoses. Collaboration between dermatologists and rheumatologists should be reviewed with a view to improving effective PsA screening.

Keywords: Psoriasis; biologicals; comorbidity; management; psoriatic arthritis; screening.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Psoriatic* / diagnosis
  • Arthritis, Psoriatic* / epidemiology
  • Cross-Sectional Studies
  • Dermatologists / statistics & numerical data
  • Dermatology / statistics & numerical data
  • Female
  • Germany / epidemiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mass Screening*
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data
  • Prospective Studies
  • Referral and Consultation / statistics & numerical data
  • Surveys and Questionnaires
  • Ultrasonography

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