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Psoriatic Arthritis: Identifying Patients

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The aim of this article is to discuss tools that can be used to identify patients with psoriasis, attending a dermatology clinic, who may have psoriatic arthritis and should be referred to rheumatology. Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy, which may affect 6-42% of people with psoriasis. The diagnosis of psoriatic arthritis can be missed because patients do not always present with joint symptoms and instead can have inflammatory back pain, tendon inflammation (tendosynovitis), pain where the tendons meet the bones (enthesitis) or diffuse swelling of fingers or toes (dactylitis). When seeing a patient with psoriasis it is important to consider whether there are any signs and symptoms that may indicate that the patient has developed an inflammatory arthritis. The NICE guideline for psoriasis states that an annual assessment should be offered to everyone with any form of psoriasis; the Psoriasis Epidemiological Screening Tool (PEST) is suggested. The key is that if there is a suspicion of inflammatory arthritis the patient should be referred to rheumatology for a further review. The sooner a diagnosis is made, the sooner a patient can commence treatment to manage their symptoms and prevent loss of function.


Document Type: Research Article

Publication date: June 1, 2016

More about this publication?
  • Dermatological Nursing is the quarterly, peer-reviewed journal of the British Dermatological Nursing Group (BDNG) and the UK's only quality dermatological nursing journal. It aims to provide cutting-edge articles on the treatment and management of dermatological conditions and the care of patients with skin problems. While the focus is on dermatological nursing, the information included is relevant to other healthcare professionals.
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