Burden of arthropathy in psoriasis: Evidence from a tertiary care hospital in Sri Lanka

Psoriatic arthritis (PsA) is an inflammatory articular disorder, associated with cutaneous psoriasis. Epidemiology of PsA widely varies in literature and none is based upon Sri Lankan population. A descriptive cross sectional study was conducted among 118 diagnosed patients with psoriasis attending a dermatology clinic at the National Hospital of Sri Lanka. Prevalence of PsA was 28%. Among PsA patients, majority (57.6%) were males, mean age was 46 years (SD=13.0); ranging from 23-74 years. Polyarthritis mimicking rheumatoid arthritis (39%) and spondyloarthitrs (21%) were the commonest types. Age >20 years; chronic plaque type of psoriasis; duration of psoriasis >2yrs; presence of nail changes; scalp involvement; and >10% body surface area involvement were factors significantly associated with development of PsA (p<0.05). Mean DLQI level among patients with PsA was 9.0 (SD=3.26), while it was 2.58 (SD=2.18) among psoriatic patients without arthritis. Chronic, extensive psoriasis with nails and scalp involvement should point towards regular, repeated screening for arthropathy to implicate optimum management.