Dr. Nancy Reid
Psoriatic disease is an autoimmune disorder which has a myriad of systemic inflammatory effects and comorbid conditions. Early recognition of the psoriatic arthritis (PSA) component of this disease is imperative in reducing or eliminating structural, irreversible joint damage. Much of the time, dermatology healthcare providers (HCPs) are the front line HCPs in the diagnosis of psoriasis vulgaris, as skin psoriasis (PSO) often predates PSA. Unfortunately, many PSA patients are missed by dermatologists and go on to suffer with active disease before recognition or a formal diagnosis is made. There have been some distinct “phases” of PSA described in the literature such as preclinical PSA, subclinical PSA, and prodromal PSA which define possible “stages” of a psoriatic patient’s development of PSA overtime. This paper aims to review emerging literature on the subject of preclinical PSA, while pulling out clinical pearls that providers can use to help recognize these patients. A search was conducted through PubMed to identify clinical trials, systematic reviews, clinical reviews, and case studies published to date on this topic. Dermatology HCPs appropriately recognizing the unseen attributes of PSA in their PSO patients will ultimately aid in earlier diagnosis PSA, which can prevent long term structural joint damage and years of patient suffering.
Neal A. Recognizing Pre-Clinical Psoriatic Arthritis in Order to Improve Patient Outcomes. Lynchburg Journal of Medical Science. 2021; 3(4).
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