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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

Rivista di Dermatologia e Malattie Sessualmente Trasmesse


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2017 October;152(5):458-73

DOI: 10.23736/S0392-0488.17.05680-2

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Management of psoriatic arthritis among cutaneous psoriasis patients: from pathogenesis to therapy

Pauline HOELT 1, Cyrille CONFAVREUX 2, Denis JULLIEN 1, Axel P. VILLANI 1

1 Department of Dermatology, Edouard Herriot Hospital, Claude Bernard Lyon I University, Lyon, France; 2 Department of Rheumatology, Edouard Herriot Hospital, Claude Bernard Lyon I University, Lyon, France


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Psoriatic arthritis (PsA) is an inflammatory rheumatism belonging to spondyloarthritis family and which occurs in about 30% of patients with psoriasis. The pathogenesis entails a genetic predisposition, environmental and immunologic factors. Most of the time, cutaneous lesions precede apparition of articular manifestations and dermatologists who treat psoriatic patients have to regularly screen for early PsA, especially in patients with risk factors (notably nail psoriasis). Early detection greatly increases the chances for successful treatment and can prevent slow joint destruction. EULAR and GRAPPA have recently published PsA treatment recommendations. Pharmacological therapies for PsA begin with non-steroidal anti-inflammatory drugs, then conventional synthetic as methotrexate, and lastly biological disease-modifying anti-rheumatic drugs. There are significant metabolic comorbidities and increased cardiovascular morbidity in patients with PsA. This aspect must be taken into account in PsA management by pharmaceutical and non-pharmaceutical approach (including educational programs). Close collaboration between dermatologists, rheumatologists and primary care clinicians is recommended to provide optimum care and to prevent the occurrence of structural damages or quality of life alteration.


KEY WORDS: Psoriatic arthritis - Spondylarthritis - Psoriasis - Therapeutics

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Publication History

Issue published online: September 12, 2017
Article first published online: May 23, 2017
Manuscript accepted: May 12, 2017
Manuscript received: May 4, 2017

Per citare questo articolo

Hoelt P, Confavreux C, Jullien D, Villani AP. Management of psoriatic arthritis among cutaneous psoriasis patients: from pathogenesis to theapy. G Ital Dermatol Venereol 2017;152:458-73. DOI: 10.23736/S0392-0488.17.05680-2

Corresponding author e-mail

axel.villani@chu-lyon.fr