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Psoriatic arthritis is the most common comorbidity found in patients with psoriasis, occurring in approximately 30% of cases. However, initial presenting symptoms can be subtle. In fact, 85% patients have 10-12 years of warning signs leading up to clinical manifestation. Furthermore, severity of psoriatic skin manifestations may not perfectly correlate with arthritic involvement as 25% of individuals with mild cutaneous psoriasis may have some evidence of psoriatic arthritis. Unfortunately, if not diagnosed (and therefore treated) early there is potential for material morbidity and progressive disability.

In this lecture, Alice B. Gottlieb, MD, PhD and Joseph F. Merola, MD, MMSc highlight the importance of physician-conducted as well as patient-administered screening for psoriatic arthritis in psoriasis patients. Smartphone-based apps from the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) can empower patients to screen their symptoms (Psoriasis Epidemiology Screening Tool, PEST) and even the severity of their symptoms (Psoriatic Arthritis Impact of Disease Questionnaire, PsAID) prior to seeing their Dermatologist. These tools can be used to not only educate patients about the early warning signs (e.g. plantar fasciitis, enthesitis of the Achilles tendon, sacraliliitis, etc), but also monitor disease response to therapy and modify as needed.

Drs. Merola and Gottlieb concluded by emphasizing the importance of open-communication with patients to assess both their skin goals, taking a thorough history to uncover other early warning signs of psoriatic arthritis (e.g. pain in joints, stiffness after prolonged rest, sausage digits, axial/spine stiffness or pain), and being cognizant of other comorbidities patients may have (e.g. inflammatory bowel disease) to optimize their treatment regimen.