Psoriatic arthritis (PsA) is an inflammatory form of arthritis that appears approximately 7–10 years after psoriasis and remains undiagnosed in most of patients. Currently, only a few quantitative and succinct PsA-risk prediction models are available. The aim of this study was to establish and validate a prediction model for quantitatively assessing the risk of PsA in moderate and severe plaque psoriasis patients. A non-interventional and cross-sectional study was conducted. Demographic, clinical, and laboratory records were collected and blindly reviewed. Logistic regression was used to develop this prediction model. With C-index and calibration curve, internal validation was performed. Five-fold cross validation, external validation and decision curve analysis (DCA) were also applied to assess this model. Among 405 patients, 111 patients had PsA. Arthralgia (OR = 39.346; 95% CI: 20.139–82.579), C-reactive protein (OR = 2.008; 95% CI: 1.051–3.838), lymphocyte level (OR = 0.341; 95% CI: 0.177–0.621), hypertension (OR = 0.235; 95% CI: 0.077–0.660) and disease duration (OR = 1.033; 95% CI: 0.998–1.071) were identified as potential predictors affecting the risk of transition from moderate and severe PsO to PsA. C-index for the prediction nomogram was 0.911 (95% CI: 0.879–0.943), and was confirmed to be 0.905 through 1000-time bootstrapping internal validation. Cross validation and external validation were preformed and proved the accuracy and generalizability of this prediction model. This study establishes a quantitative predictive nomogram with good predictive power for assessing the risk of PsA in patients with moderate and severe PsO.

The objective of this study is to identify the potential risk factors for progression from subclinical to clinical psoriatic arthritis (PsA). A retrospective, longitudinal, case–control study was conducted at a single hospital, including 25 patients with clinically confirmed PsA in the case group and 137 controls without confirmed PsA. All patients in both groups had a medical history of subclinical PsA. Various baseline covariates were collected from all patients when they had a status of subclinical PsA. Univariate, multivariate, stratified, and interaction analyses were employed to identify potential risk factors of transiting to clinical PsA from subclinical PsA. In multivariate logistic regression analysis, older age (OR 10.15, 95% CI 2.79–36.91, p = 0.00), alcohol drinking (OR 3.43, 95% CI 1.17–10.12, p = 0.03), elevated high-sensitivity C-reactive protein (hs-CRP) (OR 1.05, 95% CI 1.01–1.09, p = 0.03) were identified as risk factors for transition from subclinical to clinical PsA. Stratified and logistic regression analyses suggest a significant interaction between age and fatty liver. For patients aged less than 45 years old, the association between fatty liver and clinical PsA was statistically significant. Older age, alcohol drinking, elevated hs-CRP, and the presence of fatty liver at less than 45 years old appear to increase the risk of transition from subclinical to clinical PsA. These findings call for a need to manage these risk factors.

目的 探讨多学科联合门诊在银屑病性关节炎(PsA)诊断和治疗中的意义.方法 回顾性分析2015年10月-2019年10月四川大学华西医院银屑病多学科联合门诊就诊的69例患者的病史资料,对诊断为银屑病性关节炎患者的临床特征进行分析.结果 银屑病性关节炎36例,无关节受累及患其他关节炎者共33例.银屑病性关节炎患者中,男女比例为2∶1,关节发病年龄平均(38.97±12.72)岁;皮损先于关节症状出现者33例(91.67％);银屑病外周关节高频超声显示常见受累关节为手小关节,常见异常征象包括滑膜炎、附着点炎等.多因素Logistics回归分析显示:甲受累及银屑病病程＞10年与PsA发生相关.结论 银屑病性关节炎易被误诊及延迟诊断,其早期发现和诊治需要多学科合作,其中,皮肤科医生应针对有关节症状及高风险的银屑病患者进行早期筛查及转诊.

目的:比较中重度银屑病和银屑病性关节炎患者的关节超声表现的差异.方法:纳入2014年2月至2017年8月住院期间接受肌骨超声检查的中重度银屑病和银屑病性关节炎患者.评估两组患者的附着点炎、滑膜炎、骨侵蚀、关节间隙狭窄、甲病变等关节相关病变.结果:与310例中重度银屑病患者相比,112例银屑病性关节炎患者的年龄更大、病程更长、关节超声异常表现比例更高.96.4％(108/112)的银屑病性关节炎患者和81.9％(254/310)的中重度银屑病患者超声显示关节改变.结论:本研究中重度银屑病患者和银屑病性关节炎患者关节超声异常比较均较高,临床上应重视中重度银屑病患者的关节改变筛查.