PMID- 30343350
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 2193-8210 (Print)
IS  - 2190-9172 (Electronic)
VI  - 8
IP  - 4
DP  - 2018 Dec
TI  - Clinical and Genetic Risk Factors Associated with Psoriatic Arthritis among 
      Patients with Psoriasis.
PG  - 593-604
LID - 10.1007/s13555-018-0266-x [doi]
AB  - INTRODUCTION: Psoriatic arthritis (PsA) is a chronic, inflammatory arthritis that 
      affects an estimated 30% of patients with psoriasis. PsA is underdiagnosed in 
      primary care and dermatology clinics due to a variety of reasons, including 
      failure of healthcare providers to ask about symptoms, overlap of symptoms and 
      signs with other rheumatologic conditions, and lack of a specific diagnostic 
      test. A delay in PsA diagnosis and treatment, even as short as 6 months, can lead 
      to decreased quality of life, increased joint damage, and worse long-term 
      physical function. In this study, we sought to identify the clinical and genetic 
      factors that help discriminate patients with PsA from those with cutaneous 
      psoriasis only. METHODS: We analyzed a cohort of 974 psoriasis patients at an 
      academic medical center, of whom 175 had confirmed PsA, and performed univariate, 
      multivariate, and predictive modeling to determine factors associated with PsA. 
      RESULTS: The univariate analysis revealed significant positive associations of 
      PsA with age, nail involvement, scalp involvement, skin fold involvement, 
      elbow/knee involvement, psoriasis severity, plaque subtype, erythrodermic 
      subtype, hypertension, type 2 diabetes, and coronary artery disease, and a 
      significant negative association of PsA with the human leukocyte antigen 
      (HLA)-C*06:02 allele. In the multivariate analysis, nail involvement, type 2 
      diabetes, and pustular psoriasis remained significantly associated with PsA, 
      while HLA-C*06:02 positivity remained protective. There was a trend towards an 
      association of PsA with older age, younger age of psoriasis onset, and skin fold 
      involvement, while there was protective trend for smoking. A predictive model 
      including both clinical and genetic factors showed reasonable discriminative 
      ability between psoriasis and PsA, with an area under the curve of 0.87 for a 
      receiver operating characteristic curve. CONCLUSION: This study identified a 
      number of clinical and genetic features that could help stratify patients who are 
      at higher risk for having PsA and for whom rheumatology referral may be 
      beneficial.
FAU - Yan, Di
AU  - Yan D
AD  - Department of Dermatology, University of California San Francisco, San Francisco, 
      CA, USA.
FAU - Ahn, Richard
AU  - Ahn R
AD  - Department of Microbiology, Immunology and Molecular Genetics, Institute for 
      Quantitative and Computational Biosciences, University of California, Los 
      Angeles, CA, USA.
FAU - Leslie, Stephen
AU  - Leslie S
AD  - Centre for Systems Genomics, Schools of Mathematics and Statistics, and 
      BioSciences, The University of Melbourne, Melbourne, VIC, Australia.
FAU - Liao, Wilson
AU  - Liao W
AUID- ORCID: 0000-0001-7883-6439
AD  - Department of Dermatology, University of California San Francisco, San Francisco, 
      CA, USA. wilson.liao@ucsf.edu.
LA  - eng
GR  - R01 AR065174/AR/NIAMS NIH HHS/United States
GR  - U01 AI119125/AI/NIAID NIH HHS/United States
PT  - Journal Article
DEP - 20181020
PL  - Switzerland
TA  - Dermatol Ther (Heidelb)
JT  - Dermatology and therapy
JID - 101590450
PMC - PMC6261122
OTO - NOTNLM
OT  - Association
OT  - Demographics
OT  - Genetics
OT  - Prediction
OT  - Psoriasis
OT  - Psoriatic arthritis
OT  - Risk
EDAT- 2018/10/22 06:00
MHDA- 2018/10/22 06:01
PMCR- 2018/10/20
CRDT- 2018/10/22 06:00
PHST- 2018/07/23 00:00 [received]
PHST- 2018/10/22 06:00 [pubmed]
PHST- 2018/10/22 06:01 [medline]
PHST- 2018/10/22 06:00 [entrez]
PHST- 2018/10/20 00:00 [pmc-release]
AID - 10.1007/s13555-018-0266-x [pii]
AID - 266 [pii]
AID - 10.1007/s13555-018-0266-x [doi]
PST - ppublish
SO  - Dermatol Ther (Heidelb). 2018 Dec;8(4):593-604. doi: 10.1007/s13555-018-0266-x. 
      Epub 2018 Oct 20.