• Shirley Braga Lima Gamonal, Aloisio Carlos Couri Gamonal, Marcos Antônio Fernandes Brandão, Laura Andrade Junqueira, Pollyana Mendonça de Assis, and Nádia Rezende Barbosa Raposo.
• MD, MSc, PhD. Researcher, Núcleo de Pesquisa e Inovação em Ciências da Saúde (NUPICS), Faculty of Pharmacy, Universidade Federal de Juiz de Fora, Juiz de Fora (MG), Brazil; Physician and Professor, Núcleo de Pesquisa em Dermatologia (NUPEDE), Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil.
• Sao Paulo Med J. 2021 Aug 1; 139 (5): 476-480.

BackgroundPsoriatic arthritis is the most frequent and impactful comorbidity among psoriatic patients and appears in most cases after skin disease. Dermatologists play a key role in its early diagnosis and treatment.ObjectiveTo determine the prevalence of psoriatic arthritis and associated variables among patients with plaque psoriasis seen at a reference center for treating psoriasis.Design And SettingRetrospective cross-sectional study conducted among 300 patients at an outpatient clinic in a university center in Juiz de Fora, MG, Brazil.MethodsStandardized records of 300 patients with plaque psoriasis were examined. Demographic data and medical variables relating to psoriasis (Psoriasis Area and Severity Index (PASI), family history, age at onset and disease progression) and psoriasis arthritis (CASPAR criteria) were evaluated. Laboratory and radiographic tests in the medical records were reviewed.ResultsSeventy-three (24.3%) of these 300 patients with plaque psoriasis had psoriatic arthritis. Asymmetric oligoarthritis (58.9%) was the most common clinical form, followed by polyarthritis (20.5%), distal interphalangeal arthritis (15.2%) and spondyloarthritis (5.4%). Dactylitis was present in 21.9% and enthesitis in 35.6% of patients. Compared with patients without arthritis, patients with arthritis had higher average age, higher frequency of positive family history of psoriasis, longer duration of evolution and higher PASI rates.ConclusionPsoriatic arthritis is often underdiagnosed. Since dermatologists perform the initial approach, these professionals need to be trained to diagnose this comorbidity and treat it, together with rheumatologists.

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