UTILITY OF A SELF ADMINISTERED QUESTIONNAIRE AS A TOOL FOR SCREENING JOINT INVOLVEMENT UNDERWAY PSORIASIS

Background: The psoriatic arthropathy (AP) is a chronic inflammatory disease of skeletal muscle associated with psoriasis that can involve the synovium, cartilage, bone, tendons and entheses. The identification of individuals with AP can be difficult due to both the wide variability of the clinical manifestations, and the lack of bio-specific markers of the disease. The dermatologist is not always able to recognize the clinical manifestations of this disease and therefore a multidisciplinary approach between the dermatologist and rheumatologist in this context is of considerable importance in order to make an early diagnosis and target treatment. Methods: We have developed a questionnaire that can be self-administered to psoriasis patients to identify those who are more likely to be affected by rheumatology. There are 11 questions with the answers:, “no”, “I don't know”, “I don't understand”, that patients can compile themselves in the waiting room before their visit. Results: 106 questionnaires were collected as part of the surgery “psoriasis” of the Dermatology Clinic of the Hospital. All patients who reported joint symptoms and who did not have a diagnosis of psoriatic arthritis (49) were subsequently evaluated by the rheumatologist. The survey showed a diagnosis of AP in 7 cases and suspected AP in another 5 cases. Among the 7 patients with ascertained AP: 86% reported back pain, 71% reported the presence of ”sausage fingers” and another 71% reported waking up with joint or muscle pain which resolved after at least half an hour of movement.Conclusions: Having identified in a simple way arthropathic complications in a group of patients who were already followed for only psoriasis, the self-administered questionnaire is, therefore, a simple and economical tool to help identify patients affected by psoriasis to be sent to the rheumatologist to confirm the diagnosis of psoriatic arthritis.